Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10564
Revised: October 31, 2013
Accepted: January 6, 2014
Published online: August 14, 2014
Processing time: 361 Days and 14.4 Hours
AIM: To evaluate the impact of long term permanent hypoxemia noticed in patients with non operated congenital cyanogenic cyanotic cardiopathy on liver stiffness.
METHODS: We included ten adult patients with non operated inoperate cyanotic cardiopathy and ten matched patients for age and gender admitted to the gastroenterology department for proctologic diseases; Clinical and laboratory data were collected [age, gender, body mass index, oxygen saturation, glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), glycemia and cholesterol]. Measurement of hepatic stiffness by transient elastography was carried out in all patients using the Fibroscan device. All patients underwent an echocardiography to eliminate congestive heart failure.
RESULTS: Among the patients with cyanotic cardiopathy, median liver stiffness 5.9 ± 1.3 kPa was greater than control group (4.7 ± 0.4 kPa) (P = 0.008). Median levels of GOT, GPT, gamma-glutamyltransferase, glycemia and cholesterol were comparable in cardiopathy and control group. In regression analysis including age, gender, body mass index, oxygen saturation, GOT, GPT, glycemia, cholesterol showed that only oxygen saturation was related to liver stiffness (r = -0.63 P = 0.002).
CONCLUSION: Chronic permanent hypoxemia can induce mild increase of liver stiffness, but further studies are needed to explore the histological aspects of liver injury induced by chronic permanent hypoxemia.
Core tip: Our study is the first one to be carried out in humans and to evaluate the long term effect of hypoxemia on liver stiffness. The clinical model is provided by non operated adult patients with cyanotic cardiopathy. Heart failure, that can overestimate liver stiffness, is eliminated by echocardiography in all patients. The results show that long term hypoxemia leads to only mild liver stiffness elevation.