Impaired Cardiac Reserve on Dobutamine Stress Echocardiography Predicts the Development of Hepatorenal Syndrome
Anoop N Koshy, Omar Farouque, Benjamin Cailes, Adam Testro, Jay Ramchand, Jithin K Sajeev, Hui-Chen Han, Piyush M Srivastava, Elizabeth F Jones, Hamid Salehi, Andrew W Teh, Han S Lim, Paul Calafiore, Paul J Gow
AMERICAN JOURNAL OF GASTROENTEROLOGY | LIPPINCOTT WILLIAMS & WILKINS | Published : 2020
OBJECTIVES: Cardiac dysfunction has been implicated in the genesis of hepatorenal syndrome (HRS). It is unclear whether a low cardiac output (CO) or attenuated contractile response to hemodynamic stress can predict its occurrence. We studied cardiovascular hemodynamics in cirrhosis and assessed whether a diminished cardiac reserve with stress testing predicted the development of HRS on follow-up. METHODS: Consecutive patients undergoing liver transplant workup with dobutamine stress echocardiography (DSE) were included. CO was measured at baseline and during low-dose dobutamine infusion at 10 μg/kg/min. HRS was diagnosed using guideline-based criteria. RESULTS: A total of 560 patients underw..View full abstract
Awarded by Royal Australasian College of Physicians Blackburn Scholarship
A.N.K. is a recipient of the National Health and Medical Research Council of Australia/National Heart Foundation Post-Graduate Scholarship and Royal Australasian College of Physicians Blackburn Scholarship (1150874).