ArticleUnited European gastroenterology journal2023
Diastolic dysfunction is associated with cardiac decompensation after transjugular intrahepatic portosystemic shunt in patients with liver cirrhosis.
Article in United European gastroenterology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Cardiovascular risk assessment and predictors of cardiac decompensation after transjugular intrahepatic portosystemic shunt in patients with cirrhosis.World journal of gastroenterology · 2025Pooled it
- Cirrhotic cardiomyopathy: a systematic review and meta-analysis of prevalence across various diagnostic approaches.Annals of Saudi medicinePooled it
- TIPS in Older Adults: Reserve-Based Risk Stratification and Practical Approach.Journal of clinical medicine · 2026Review
- Effectiveness of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) in an interdisciplinary setting at a large tertiary center.Wiener klinische Wochenschrift · 2026Article
- Association of NT-proBNP and sST2 with Diastolic Dysfunction in Cirrhotic Patients and Its Therapeutic Implications.International journal of molecular sciences · 2025Article
- Insertion of a transjugular intrahepatic portosystemic shunt leads to sustained reversal of systemic inflammation in patients with decompensated liver cirrhosis.Clinical and molecular hepatology · 2025Article
- Diastolic dysfunction is associated with cardiac decompensation after transjugular intrahepatic portosystemic shunt in patients with liver cirrhosis.United European gastroenterology journal · 2023Article
- The Hepato-Cardio-Renal Axis in Cirrhosis: Hemodynamic and Mechanistic Insights, Diagnostic Biomarkers, and Expanding Therapeutic Horizons.Discoveries (Craiova, Romania)Review
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Authors and funding
12 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsAbout 20% of patients develop cardiac decompensation within the first year after transjugular intrahepatic portosystemic shunt (TIPS) insertion. However, risk factors for cardiac decompensation remain poorly defined. We aimed to evaluate predictors of cardiac decompensation after TIPS insertion in a large, well-defined cohort of patients with liver cirrhosis.
methods234 cirrhotic patients who received a TIPS at Hannover Medical School were retrospectively followed up for one year to assess the incidence of cardiac decompensation. Echocardiographic parameters and established diagnostic criteria for cardiac impairment (e.g. by the American Society of Echocardiography/ European Association of Cardiovascular Imaging (ASE/EACVI)) were investigated for an association with cardiac decompensation in a competing risk analysis. Survival was analyzed using a multivariable cox regression analysis adjusting for Freiburg index of post-TIPS survival.
resultsPredominant TIPS indication was ascites (83%). Median age was 59 years, median MELD-score 12% and 58% were male. Overall, 41 patients (18%) developed cardiac decompensation within one year after TIPS insertion. Diastolic dysfunction according to the ASE/EACVI was diagnosed in 26% of patients at baseline and was linked to a significantly higher risk for cardiac decompensation (p = 0.025) after TIPS. When investigating individual echocardiographic baseline parameters, only pathological E/A (<0.8 or >2) was identified as a risk factor for cardiac decompensation (p = 0.015). Mortality and liver transplantation (n = 50) were significantly higher among patients who developed cardiac decompensation (HR = 5.29, p < 0.001) as well as in patients with a pathological E/A (HR = 2.34, p = 0.006). Cardiac high-risk status (44% of patients) was strongly linked to cardiac decompensation (HR = 2.93, p = 0.002) and mortality (HR = 2.24, p = 0.012).
conclusionCardiac decompensation after TIPS is a frequent and important complication and is associated with reduced survival. American Society of Echocardiography/EACVI criteria and E/A seem to be the best parameters to predict the cardiac risk in cirrhotic patients undergoing TIPS insertion.
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