vWF, a screening tool for detection of hepatopulmonary syndrome in patients with liver cirrhosis
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vWF, a screening tool for detection of hepatopulmonary syndrome in patients with liver cirrhosis. / Horvatits, Thomas; Drolz, Andreas; Roedl, Kevin; Herkner, Harald; Ferlitsch, Arnulf; Perkmann, Thomas; Müller, Christian; Trauner, Michael; Schenk, Peter; Fuhrmann, Valentin.
In: J HEPATOL, Vol. 61, No. 3, 2014, p. 544-549.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - vWF, a screening tool for detection of hepatopulmonary syndrome in patients with liver cirrhosis
AU - Horvatits, Thomas
AU - Drolz, Andreas
AU - Roedl, Kevin
AU - Herkner, Harald
AU - Ferlitsch, Arnulf
AU - Perkmann, Thomas
AU - Müller, Christian
AU - Trauner, Michael
AU - Schenk, Peter
AU - Fuhrmann, Valentin
N1 - Copyright © 2014. Published by Elsevier B.V.
PY - 2014
Y1 - 2014
N2 - BACKGROUND & AIMS: Hepatopulmonary syndrome (HPS) occurs in 20-30% of patients with liver cirrhosis and is associated with a >2 fold increased mortality. Endothelial dysfunction seems to play a central role in its pathogenesis. von Willebrand factor antigen (vWF-Ag), an established marker of endothelial dysfunction, is significantly elevated in patients with liver cirrhosis, portal hypertension and in experimental HPS. Aim of the present study was to evaluate the impact of vWF-Ag as screening marker for presence of HPS in patients with stable cirrhosis.METHODS: 145 patients with stable liver cirrhosis were screened for presence of HPS in this prospective cohort type cross sectional diagnostic study. vWF-Ag and SaO2 levels were assessed at time of screening for HPS. Criteria of HPS were fulfilled in 31 (21%) patients.RESULTS: vWF-Ag levels were significantly higher in patients with HPS compared to patients without HPS (P < 0.001). Furthermore, vWF-Ag correlated significantly with gas exchange in HPS positive patients (P < 0.05). vWF-Ag is an independent predictor of HPS after correction for sex, age, model for endstage-liver disease (MELD) and hepatic venous pressure gradient (HVPG) (OR per 1% increase of vWF-Ag: 1.02, 95% CI: 1.00-1.04, P < 0.05). The best cut off was 328% at a sensitivity of 100% and specificity of 53.5%; positive predictive value: 36.9%; negative predictive value: 100%.CONCLUSION: HPS is associated with elevated vWF-Ag levels. vWF-Ag may be a useful screening tool for early detection of HPS. Further studies investigating vWF-Ag in HPS will be needed to confirm our findings.
AB - BACKGROUND & AIMS: Hepatopulmonary syndrome (HPS) occurs in 20-30% of patients with liver cirrhosis and is associated with a >2 fold increased mortality. Endothelial dysfunction seems to play a central role in its pathogenesis. von Willebrand factor antigen (vWF-Ag), an established marker of endothelial dysfunction, is significantly elevated in patients with liver cirrhosis, portal hypertension and in experimental HPS. Aim of the present study was to evaluate the impact of vWF-Ag as screening marker for presence of HPS in patients with stable cirrhosis.METHODS: 145 patients with stable liver cirrhosis were screened for presence of HPS in this prospective cohort type cross sectional diagnostic study. vWF-Ag and SaO2 levels were assessed at time of screening for HPS. Criteria of HPS were fulfilled in 31 (21%) patients.RESULTS: vWF-Ag levels were significantly higher in patients with HPS compared to patients without HPS (P < 0.001). Furthermore, vWF-Ag correlated significantly with gas exchange in HPS positive patients (P < 0.05). vWF-Ag is an independent predictor of HPS after correction for sex, age, model for endstage-liver disease (MELD) and hepatic venous pressure gradient (HVPG) (OR per 1% increase of vWF-Ag: 1.02, 95% CI: 1.00-1.04, P < 0.05). The best cut off was 328% at a sensitivity of 100% and specificity of 53.5%; positive predictive value: 36.9%; negative predictive value: 100%.CONCLUSION: HPS is associated with elevated vWF-Ag levels. vWF-Ag may be a useful screening tool for early detection of HPS. Further studies investigating vWF-Ag in HPS will be needed to confirm our findings.
U2 - 10.1016/j.jhep.2014.04.025
DO - 10.1016/j.jhep.2014.04.025
M3 - SCORING: Journal article
C2 - 24798623
VL - 61
SP - 544
EP - 549
JO - J HEPATOL
JF - J HEPATOL
SN - 0168-8278
IS - 3
ER -