Cirrhosis, Liver Cirrhoses, Liver Diseases, Portal Hypertension
Conditions
Keywords
Hemodynamic assessments, Echocardiography, MR-Elastography, Liver vein catheterization, Liver Cirrhosis, Cirrhotic cardiomyopathy, Cirrhotic complications, Magnetic Resonance Imaging
Brief summary
Liver cirrhosis is a chronic disease characterized by a progressive accumulation of fibrosis, loss of liver function and portal hypertension leading to several hemodynamic changes.The exact pathophysiological mechanisms causing the hyperdynamic alterations in cirrhosis are not fully elucidated. Aim: The aim of the study is to assess hemodynamic alterations in liver cirrhosis by non-invasive MRI and echocardiography compared to portal hypertension measured with liver vein catheterization (HVPG, hepatic vein pressure gradient). Furthermore, the aim is to explore hemodynamic differences between cirrhotic patients and healthy subjects. Study design and cohort: The study has a cross-sectional design and a cohort with 99 patients with liver cirrhosis - with and without complications and 27 healthy volunteers. The patients are recruited at the Gastrounit Hvidovre University Hospital. The day before the first visit patients are hospitalized and fasting overnight. At first visit liver vein catheterization (LVC) and echocardiography are performed. Second visit must be performed within 4 weeks after first visit. At the second visit patients are fasting minimum 6 hours before having MR-flow scanning, cardiac-MR and MR-Elastography (MR-E). The healthy volunteers are only offered MR-flow scanning, cardiac MR and MR-E as well as urine- and blood tests Follow-up for liver-related clinical outcome and mortality in medical records
Detailed description
MR elastography, cardiac scan, phase contrast MRI of blood flow compared to LVC
Interventions
None listed
Sponsors
Hvidovre University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 82 Years
Healthy volunteers
Yes
Inclusion criteria
Patients with liver cirrhosis or portal hypertension Patient of more than 18 and less than 82 years of age
Exclusion criteria
Patients who are unable to give informed consent Patients with absolute contraindication for MRI Pregnant women Patient with severe hemodynamic comorbidity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MRI-flow (mL/min) in splanchnic arterial compared to clinical severity of cirrhosis and to portal hypertension measured as HVPG (mmHg) during liver vein catheterization | During MRI-scan | To compare the flow and cardiac parameters measured by MRI with disease progression and with HVPG (mmHg) measured during liver vein catheterization (LVC) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hemodynamic alterations in patients with liver cirrhosis measured as flow (mL/min) in relevant vessels compared to flow in healthy subjects | During MRI-scan | To characterize flow in cirrhotic patients compared to healthy subjects |
| Measurements of hemodynamic alterations compared with different severity of liver cirrhosis defined by Child Pugh and MELD score | During MRI-scan | To assess the relation between severity of cirrhosis with changes in flow and cardiac-MRI |
| MR-elastography measurements (kPa) to characterize severity of cirrhosis categorized with Child Pugh, MELD and HVPG | During MRI-scan | To assess the relation between severity of cirrhosis and changes in liver and spleen stiffness |
Countries
Denmark
Outcome results
None listed