Influence of TIPS on laboratory and cardiac parameters in patients with Budd-Chiari Syndrome
摘要
Transjugular intrahepatic portosystemic shunt (TIPS) is a commonly used method to treat Budd-Chiari syndrome (BCS). This study aimed to assess the immediate and mid-term changes in echocardiographic patterns and laboratory parameters post-TIPS and to determine the implications of these changes for patient management and prognosis.
MethodsFrom 2021 to 2023, a retrospective cohort study was conducted of BCS patients treated at Ain Shams University’s Tropical Medicine Department. About 23 patients underwent laboratory and echocardiographic follow-up examinations at baseline, one month, and six months following TIPS, including transthoracic echocardiograms and electrocardiograms.
ResultsPost-TIPS, Blood Urea Nitrogen (BUN) levels decreased significantly from 14.16 ± 8.71 to 10.52 ± 5.66 (mg/dL post-TIPS (p = 0.007). Albumin levels modestly increased from 3.34 ± 0.85 to 3.36 ± 0.51 post-TIPS (p = 0.026), suggesting enhanced hepatic synthesis. Echocardiographically, the left atrial volume index (LAVI) increased from 21.91 ± 6.06 to 26.09 ± 5.39 (mL/m2) post-TIPS (p = 0.015). E velocity decreased from 40.35 ± 3.24 to 36.04 ± 7.3 (p = 0.031), and global longitudinal strain (GLS) showed improvement, reflecting adaptive cardiac responses to altered hemodynamics.
ConclusionTIPS improved renal and hepatic function parameters. With respect to cardiac function, although changes in LAVI, E-velocity and GLS were mild and remained within the normal range but 6-month changes of GLS were positive showing an improvement by TIPS. So only a small number of patients with pathological cardiac conditions may need follow-up monitoring to identify and address potential complications at an early stage.