Evidence map›Paper›PMID 33044649›Full record

ArticleEuropean radiology2021

Haemodynamic changes in cirrhosis following terlipressin and induction of sepsis-a preclinical study using caval subtraction phase-contrast and cardiac MRI.

Manil D Chouhan, Stuart A Taylor, Alan Bainbridge, Simon Walker-Samuel, Nathan Davies, Steve Halligan, Mark F Lythgoe, Rajeshwar P Mookerjee

Open access · hybridAbstract read
In one paragraph

Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Manil D ChouhanCentre for Medical Imaging, Division of Medicine, UCL, University College London (UCL), London, UK.
Stuart A TaylorCentre for Medical Imaging, Division of Medicine, UCL, University College London (UCL), London, UK.
Alan BainbridgeDepartment of Medical Physics, University College London Hospitals NHS Trust, London, UK.
Simon Walker-SamuelCentre for Advanced Biomedical Imaging, Division of Medicine, UCL, University College London (UCL), London, UK.
Nathan DaviesInstitute for Liver and Digestive Health, Division of Medicine, UCL, Royal Free Hospital, University College London (UCL), NW3 2PF, London, UK.
Steve HalliganCentre for Medical Imaging, Division of Medicine, UCL, University College London (UCL), London, UK.
Mark F LythgoeCentre for Advanced Biomedical Imaging, Division of Medicine, UCL, University College London (UCL), London, UK.
Rajeshwar P MookerjeeInstitute for Liver and Digestive Health, Division of Medicine, UCL, Royal Free Hospital, University College London (UCL), NW3 2PF, London, UK. r.mookerjee@ucl.ac.uk.
University College London · GBThe Royal Free Hospital · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

Wellcome TrustWellcome Trust WT092186
6 · The paper itself

Abstract

objectivesEffects of liver disease on portal venous (PV), hepatic arterial (HA), total liver blood flow (TLBF), and cardiac function are poorly understood. Terlipressin modulates PV flow but effects on HA, TLBF, and sepsis/acute-on-chronic liver failure (ACLF)-induced haemodynamic changes are poorly characterised. In this study, we investigated the effects of terlipressin and sepsis/ACLF on hepatic haemodynamics and cardiac function in a rodent cirrhosis model using caval subtraction phase-contrast (PC) MRI and cardiac cine MRI.

methodsSprague-Dawley rats (n = 18 bile duct-ligated (BDL), n = 16 sham surgery controls) underwent caval subtraction PCMRI to estimate TLBF and HA flow and short-axis cardiac cine MRI for systolic function at baseline, following terlipressin and lipopolysaccharide (LPS) infusion, to model ACLF.

resultsAll baseline hepatic haemodynamic/cardiac systolic function parameters (except heart rate and LV mass) were significantly different in BDL rats. Following terlipressin, baseline PV flow (sham 181.4 ± 12.1 ml/min/100 g; BDL 68.5 ± 10.1 ml/min/100 g) reduced (sham - 90.3 ± 11.1 ml/min/100 g, p < 0.0001; BDL - 31.0 ± 8.0 ml/min/100 g, p = 0.02), sham baseline HA flow (33.0 ± 11.3 ml/min/100 g) increased (+ 92.8 ± 21.3 ml/min/100 g, p = 0.0003), but BDL baseline HA flow (83.8 ml/min/100 g) decreased (- 34.4 ± 7.5 ml/min/100 g, p = 0.11). Sham baseline TLBF (214.3 ± 16.7 ml/min/100 g) was maintained (+ 2.5 ± 14.0 ml/min/100 g, p > 0.99) but BDL baseline TLBF (152.3 ± 18.7 ml/min/100 g) declined (- 65.5 ± 8.5 ml/min/100 g, p = 0.0004). Following LPS, there were significant differences between cohort and change in HA fraction (p = 0.03) and TLBF (p = 0.01) with BDL baseline HA fraction (46.2 ± 4.6%) reducing (- 20.9 ± 7.5%, p = 0.03) but sham baseline HA fraction (38.2 ± 2.0%) remaining unchanged (+ 2.9 ± 6.1%, p > 0.99). Animal cohort and change in systolic function interactions were significant only for heart rate (p = 0.01) and end-diastolic volume (p = 0.03).

conclusionsCaval subtraction PCMRI and cardiac MRI in a rodent model of cirrhosis demonstrate significant baseline hepatic haemodynamic/cardiac differences, failure of the HA buffer response post-terlipressin and an altered HA fraction response in sepsis, informing potential translation to ACLF patients. KEY POINTS: Caval subtraction phase-contrast and cardiac MRI demonstrate: • Significant differences between cirrhotic/non-cirrhotic rodent hepatic blood flow and cardiac systolic function at baseline. • Failure of the hepatic arterial buffer response in cirrhotic rodents in response to terlipressin. • Reductions in hepatic arterial flow fraction in the setting of acute-on-chronic liver failure.

Indexed as

Liver CirrhosisSepsisAnimalsHemodynamicsHumansMagnetic Resonance ImagingRatsRats, Sprague-DawleyTerlipressinTerlipressinHaemodynamicsLiverLiver CirrhosisSepsisTerlipressin

Identifiers

PMID33044649
PMCPMC7979649
OpenAlexW3092357068

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.