Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches

Hepatopulmonary syndrome is a severe complication of chronic liver diseases, significantly reducing the quality and duration of patient’s lives, the pathogenetic manifestation of which is hypoxemia and intrapulmonary vasodilation. The disease is widespread enough: according to some authors, up to 35...

Full description

Saved in:
Bibliographic Details
Main Authors: A. S. Tsymbal, M. A. Karnaushkina, O. S. Arisheva, N. D. Kislyy, Z. D. Kobalava
Format: Article
Language:Russian
Published: SINAPS LLC 2023-06-01
Series:Архивъ внутренней медицины
Subjects:
Online Access:https://www.medarhive.ru/jour/article/view/1615
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849403562922082304
author A. S. Tsymbal
M. A. Karnaushkina
O. S. Arisheva
N. D. Kislyy
Z. D. Kobalava
author_facet A. S. Tsymbal
M. A. Karnaushkina
O. S. Arisheva
N. D. Kislyy
Z. D. Kobalava
author_sort A. S. Tsymbal
collection DOAJ
description Hepatopulmonary syndrome is a severe complication of chronic liver diseases, significantly reducing the quality and duration of patient’s lives, the pathogenetic manifestation of which is hypoxemia and intrapulmonary vasodilation. The disease is widespread enough: according to some authors, up to 35 % of patients with the terminal stage of liver damage suffer from this syndrome. The main clinical manifestation is progressive dyspnea with possible occurrence of platypnea and orthodexia. Diagnosis is difficult, since the “gold standard” — transthoracic echocardiography with intravenous injection of contrast agent — is an invasive procedure requiring specific equipment, that’s why it is poorly used in medical institutions of the Russian Federation. Physical examination is used as an additional method, in which we see dyspnea, cyanosis, spider nevi, digital clubbing, but these manifestations are not highly specific. Therefore, there is an urgent need for minimally invasive, widespread diagnostic methods and clinical markers that can provide early verification of the diagnosis. This review presents data on the prevalence, pathogenesis, clinical presentation, diagnosis and treatment of this syndrome. The aim of this review is to structure the current data and the accumulated experience for an earlier verification of the diagnosis and accordingly, to apply the optimal management tactics for patients with this pathology. Liver transplantation is currently the main effective method of treatment. Patients with hepatopulmonary syndrome who underwent liver transplantation have been proven to have better survival rate.
format Article
id doaj-art-da464ec01b3240ae8f50d11b18fddfd2
institution Kabale University
issn 2226-6704
2411-6564
language Russian
publishDate 2023-06-01
publisher SINAPS LLC
record_format Article
series Архивъ внутренней медицины
spelling doaj-art-da464ec01b3240ae8f50d11b18fddfd22025-08-20T03:37:15ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642023-06-0113320321210.20514/2226-6704-2023-13-3-203-212945Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic ApproachesA. S. Tsymbal0M. A. Karnaushkina1O. S. Arisheva2N. D. Kislyy3Z. D. Kobalava4Federal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia” (RUDN University), Department of Internal Medicine with a course of cardiology and functional diagnostics named after academician V.S. MoiseevFederal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia” (RUDN University), Department of Internal Medicine with a course of cardiology and functional diagnostics named after academician V.S. MoiseevFederal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia” (RUDN University), Department of Internal Medicine with a course of cardiology and functional diagnostics named after academician V.S. MoiseevFederal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia” (RUDN University), Department of Internal Medicine with a course of endocrinology, hematology and clinical and laboratory diagnosticsFederal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia” (RUDN University), Department of Internal Medicine with a course of cardiology and functional diagnostics named after academician V.S. MoiseevHepatopulmonary syndrome is a severe complication of chronic liver diseases, significantly reducing the quality and duration of patient’s lives, the pathogenetic manifestation of which is hypoxemia and intrapulmonary vasodilation. The disease is widespread enough: according to some authors, up to 35 % of patients with the terminal stage of liver damage suffer from this syndrome. The main clinical manifestation is progressive dyspnea with possible occurrence of platypnea and orthodexia. Diagnosis is difficult, since the “gold standard” — transthoracic echocardiography with intravenous injection of contrast agent — is an invasive procedure requiring specific equipment, that’s why it is poorly used in medical institutions of the Russian Federation. Physical examination is used as an additional method, in which we see dyspnea, cyanosis, spider nevi, digital clubbing, but these manifestations are not highly specific. Therefore, there is an urgent need for minimally invasive, widespread diagnostic methods and clinical markers that can provide early verification of the diagnosis. This review presents data on the prevalence, pathogenesis, clinical presentation, diagnosis and treatment of this syndrome. The aim of this review is to structure the current data and the accumulated experience for an earlier verification of the diagnosis and accordingly, to apply the optimal management tactics for patients with this pathology. Liver transplantation is currently the main effective method of treatment. Patients with hepatopulmonary syndrome who underwent liver transplantation have been proven to have better survival rate.https://www.medarhive.ru/jour/article/view/1615hepatopulmonary syndromecirrhosishypoxemiavasodilatationsdyspneaorthodeoxiaplatypnea
spellingShingle A. S. Tsymbal
M. A. Karnaushkina
O. S. Arisheva
N. D. Kislyy
Z. D. Kobalava
Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches
Архивъ внутренней медицины
hepatopulmonary syndrome
cirrhosis
hypoxemia
vasodilatations
dyspnea
orthodeoxia
platypnea
title Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches
title_full Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches
title_fullStr Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches
title_full_unstemmed Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches
title_short Hepatopulmonary Syndrome in Patients with Liver Cirrhosis: Prevalence, Clinical Significance, Clinical Features, Therapeutic Approaches
title_sort hepatopulmonary syndrome in patients with liver cirrhosis prevalence clinical significance clinical features therapeutic approaches
topic hepatopulmonary syndrome
cirrhosis
hypoxemia
vasodilatations
dyspnea
orthodeoxia
platypnea
url https://www.medarhive.ru/jour/article/view/1615
work_keys_str_mv AT astsymbal hepatopulmonarysyndromeinpatientswithlivercirrhosisprevalenceclinicalsignificanceclinicalfeaturestherapeuticapproaches
AT makarnaushkina hepatopulmonarysyndromeinpatientswithlivercirrhosisprevalenceclinicalsignificanceclinicalfeaturestherapeuticapproaches
AT osarisheva hepatopulmonarysyndromeinpatientswithlivercirrhosisprevalenceclinicalsignificanceclinicalfeaturestherapeuticapproaches
AT ndkislyy hepatopulmonarysyndromeinpatientswithlivercirrhosisprevalenceclinicalsignificanceclinicalfeaturestherapeuticapproaches
AT zdkobalava hepatopulmonarysyndromeinpatientswithlivercirrhosisprevalenceclinicalsignificanceclinicalfeaturestherapeuticapproaches