Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis
ABSTRACT Background Estimated plasma volume status (ePVS) correlates with intravascular congestion and prognosis in patients with heart failure. The ePVS relationship with invasive hemodynamic profiling and clinical outcomes in patients with liver cirrhosis (LC) remains unclear. Methods This single‐...
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Wiley
2025-06-01
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| Online Access: | https://doi.org/10.1002/jgh3.70195 |
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| author | Esteban Kosak Lopez Phuuwadith Wattanachayakul Jose Manuel Martinez Manzano Andrew Geller Simone A. Jarrett John Malin Raul Leguizamon Tara A. John Rasha Khan Ian McLaren Alexander Prendergast Kevin Bryan Lo Zurab Azmaiparashvili |
| author_facet | Esteban Kosak Lopez Phuuwadith Wattanachayakul Jose Manuel Martinez Manzano Andrew Geller Simone A. Jarrett John Malin Raul Leguizamon Tara A. John Rasha Khan Ian McLaren Alexander Prendergast Kevin Bryan Lo Zurab Azmaiparashvili |
| author_sort | Esteban Kosak Lopez |
| collection | DOAJ |
| description | ABSTRACT Background Estimated plasma volume status (ePVS) correlates with intravascular congestion and prognosis in patients with heart failure. The ePVS relationship with invasive hemodynamic profiling and clinical outcomes in patients with liver cirrhosis (LC) remains unclear. Methods This single‐center retrospective cohort study included LC patients who underwent right heart catheterization (RHC) between 2018 and 2023. Estimated plasma volume status (ePVS) was calculated using the Strauss‐derived Duarte formula, with patients classified into high (> 5.5%) and low‐ePVS (≤ 5.5%) groups. Cox‐multivariable analysis was used to determine if ePVS was associated with all‐cause mortality within 1 year post‐RHC among transplant‐free patients. Results Of the 353 patients with LC (median age 59 years, 59% male, 45% Caucasian, and 29% African American), 79% were classified into the high‐ePVS group. Compared to the low‐ePVS group, the high‐ePVS group had significantly higher right atrial pressure (9 vs. 6 mmHg, p = 0.01), pulmonary arterial wedge pressure (14 vs. 11 mmHg, p = 0.014), cardiac output (9.8 vs. 6.4 L/min, p < 0.0001), and cardiac index (5 vs. 3.1 L/min/m2, p < 0.0001). Additionally, the high‐ePVS group exhibited a higher prevalence of cirrhosis‐related complications, including ascites, splenomegaly, and varices, and a greater likelihood of receiving orthotopic liver transplantation within 1 year (38% vs. 11%, p < 0.0001). Among transplant‐free patients, ePVS was independently associated with all‐cause mortality at 1 year (HR 1.15, 95% CI: 1.00–1.32, p = 0.048). Conclusion Our study demonstrated that ePVS was associated with intravascular congestion, hyperdynamic circulation, and cirrhosis complications. Furthermore, ePVS was independently associated with all‐cause mortality among transplant‐free LC patients. |
| format | Article |
| id | doaj-art-e4a7b563348c4b7bb8b63e573327e791 |
| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
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| series | JGH Open |
| spelling | doaj-art-e4a7b563348c4b7bb8b63e573327e7912025-08-20T03:30:25ZengWileyJGH Open2397-90702025-06-0196n/an/a10.1002/jgh3.70195Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver CirrhosisEsteban Kosak Lopez0Phuuwadith Wattanachayakul1Jose Manuel Martinez Manzano2Andrew Geller3Simone A. Jarrett4John Malin5Raul Leguizamon6Tara A. John7Rasha Khan8Ian McLaren9Alexander Prendergast10Kevin Bryan Lo11Zurab Azmaiparashvili12Department of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADivision of Pulmonary and Critical Care Medicine Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USAGastroenterology & Hepatology Division NYU Grossman School of Medicine New York USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USADivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USADepartment of Medicine; Jefferson Einstein Philadelphia Hospital Sidney Kimmel Medical College Philadelphia Pennsylvania USAABSTRACT Background Estimated plasma volume status (ePVS) correlates with intravascular congestion and prognosis in patients with heart failure. The ePVS relationship with invasive hemodynamic profiling and clinical outcomes in patients with liver cirrhosis (LC) remains unclear. Methods This single‐center retrospective cohort study included LC patients who underwent right heart catheterization (RHC) between 2018 and 2023. Estimated plasma volume status (ePVS) was calculated using the Strauss‐derived Duarte formula, with patients classified into high (> 5.5%) and low‐ePVS (≤ 5.5%) groups. Cox‐multivariable analysis was used to determine if ePVS was associated with all‐cause mortality within 1 year post‐RHC among transplant‐free patients. Results Of the 353 patients with LC (median age 59 years, 59% male, 45% Caucasian, and 29% African American), 79% were classified into the high‐ePVS group. Compared to the low‐ePVS group, the high‐ePVS group had significantly higher right atrial pressure (9 vs. 6 mmHg, p = 0.01), pulmonary arterial wedge pressure (14 vs. 11 mmHg, p = 0.014), cardiac output (9.8 vs. 6.4 L/min, p < 0.0001), and cardiac index (5 vs. 3.1 L/min/m2, p < 0.0001). Additionally, the high‐ePVS group exhibited a higher prevalence of cirrhosis‐related complications, including ascites, splenomegaly, and varices, and a greater likelihood of receiving orthotopic liver transplantation within 1 year (38% vs. 11%, p < 0.0001). Among transplant‐free patients, ePVS was independently associated with all‐cause mortality at 1 year (HR 1.15, 95% CI: 1.00–1.32, p = 0.048). Conclusion Our study demonstrated that ePVS was associated with intravascular congestion, hyperdynamic circulation, and cirrhosis complications. Furthermore, ePVS was independently associated with all‐cause mortality among transplant‐free LC patients.https://doi.org/10.1002/jgh3.70195cardiac catheterizationestimated plasma volume statushemodynamicsliver cirrhosisliver transplantation |
| spellingShingle | Esteban Kosak Lopez Phuuwadith Wattanachayakul Jose Manuel Martinez Manzano Andrew Geller Simone A. Jarrett John Malin Raul Leguizamon Tara A. John Rasha Khan Ian McLaren Alexander Prendergast Kevin Bryan Lo Zurab Azmaiparashvili Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis JGH Open cardiac catheterization estimated plasma volume status hemodynamics liver cirrhosis liver transplantation |
| title | Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis |
| title_full | Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis |
| title_fullStr | Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis |
| title_full_unstemmed | Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis |
| title_short | Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All‐Cause Mortality in Patients With Liver Cirrhosis |
| title_sort | association of estimated plasma volume status with invasive hemodynamics and all cause mortality in patients with liver cirrhosis |
| topic | cardiac catheterization estimated plasma volume status hemodynamics liver cirrhosis liver transplantation |
| url | https://doi.org/10.1002/jgh3.70195 |
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