Caracterización del síndrome cardio-hepático en pacientes con insuficiencia cardiaca agudizada entre el 2022 y 2023
| datacite.rights | http://purl.org/coar/access_right/c_f1cf | |
| dc.contributor.advisor | Clavijo Tinoco, Fair | |
| dc.contributor.advisor | González-Torres, Henry J. | |
| dc.contributor.author | Vega Castiblanco, Gabriel Andrés | |
| dc.contributor.author | Manosalva Trillos, Luis Miguel | |
| dc.date.accessioned | 2025-01-28T14:52:36Z | |
| dc.date.available | 2025-01-28T14:52:36Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | El síndrome cardio-hepático es una complicación frecuente en pacientes con insuficiencia cardiaca agudizada (ICA), caracterizada por la interacción entre la disfunción cardíaca y el daño hepático. Esta condición contribuye significativamente a la morbimortalidad en estos pacientes, particularmente en aquellos con fracción de eyección reducida. En regiones como el Caribe colombiano, la caracterización del síndrome cardio-hepático sigue siendo limitada, lo que resalta la importancia de comprender los factores clínicos y bioquímicos que contribuyen a su desarrollo. Objetivo: Caracterizar el Síndrome Cardio-hepático en Pacientes con Insuficiencia Cardiaca Agudizada entre el 2022 y 2023 en una clínica de Barranquilla entre los años 2022 y 2023 Métodos: Este estudio retrospectivo incluyó a 53 pacientes con diagnóstico de ICA tratados en una clínica de Barranquilla entre 2022 y 2023. Se realizó una caracterización sociodemográfica y clínica de los pacientes, así como una evaluación de los parámetros bioquímicos hepáticos y cardíacos. Las variables principales incluyeron fracción de eyección, biomarcadores hepáticos (bilirrubina total, TGP, TGO) y proBNP. Se emplearon modelos estadísticos multivariados para identificar factores de riesgo asociados al desarrollo de síndrome cardio-hepático. Resultados: El 42% de los pacientes con ICA presentaron características compatibles con síndrome cardio-hepático. La mayoría de estos pacientes presentaron fracción de eyección reducida (HFrEF) y una mayor prevalencia de etiología isquémica de la insuficiencia cardíaca (45%). Los niveles de bilirrubina total y transaminasas fueron significativamente más elevados en los pacientes con síndrome cardio-hepático. Además, la fracción de eyección reducida (HFrEF) se asoció con un riesgo 3.2 veces mayor de desarrollar este síndrome. Los pacientes con síndrome cardio-hepático mostraron una evolución clínica menos favorable (50% de desenlaces no favorables). Conclusiones: El síndrome cardio-hepático es una complicación frecuente en pacientes con ICA, especialmente en aquellos con fracción de eyección reducida. La evaluación temprana de los biomarcadores hepáticos y cardíacos es fundamental para identificar a los pacientes en riesgo de desarrollar este síndrome, y una intervención oportuna podría mejorar los resultados clínicos. Estos hallazgos subrayan la necesidad de un manejo integral que aborde tanto la disfunción cardíaca como las complicaciones hepáticas en esta población | spa |
| dc.description.abstract | Cardio-hepatic syndrome is a frequent complication in patients with acute decompensated heart failure (ADHF), characterized by the interaction between cardiac dysfunction and liver damage. This condition significantly contributes to morbidity and mortality, particularly in patients with reduced ejection fraction. In regions such as the Colombian Caribbean, the characterization of cardio-hepatic syndrome remains limited, highlighting the importance of understanding the clinical and biochemical factors contributing to its development. Objective: To characterize Cardiohepatic Syndrome in patients with acute heart failure at a clinic in Barranquilla between the years 2022 and 2023. Methods: This retrospective study included 53 patients diagnosed with ADHF treated at a clinic in Barranquilla between 2022 and 2023. A sociodemographic and clinical characterization of the patients was performed, as well as an evaluation of hepatic and cardiac biochemical parameters. Main variables included ejection fraction, hepatic biomarkers (total bilirubin, ALT, AST), and proBNP. Multivariate statistical models were used to identify risk factors associated with the development of cardio-hepatic syndrome. Results: 42% of the patients with ADHF presented features compatible with cardio-hepatic syndrome. Most of these patients had reduced ejection fraction (HFrEF) and a higher prevalence of ischemic etiology of heart failure (45%). Total bilirubin and transaminase levels were significantly higher in patients with cardio-hepatic syndrome. Furthermore, reduced ejection fraction (HFrEF) was associated with a 3.2-fold increased risk of developing this syndrome. Patients with cardio-hepatic syndrome had a less favorable clinical evolution, with 50% showing unfavorable outcomes. Conclusions: Cardio-hepatic syndrome is a frequent complication in patients with ADHF, especially in those with reduced ejection fraction. Early assessment of hepatic and cardiac biomarkers is essential to identify patients at risk of developing this syndrome, and timely intervention may improve clinical outcomes. These findings highlight the need for comprehensive management that addresses both cardiac dysfunction and hepatic complications in this population. | eng |
| dc.format.mimetype | ||
| dc.identifier.uri | https://hdl.handle.net/20.500.12442/16159 | |
| dc.language.iso | spa | |
| dc.publisher | Ediciones Universidad Simón Bolívar | spa |
| dc.publisher | Facultad de Ciencias de la Salud | spa |
| dc.rights.accessrights | info:eu-repo/semantics/embargoedAccess | |
| dc.subject | Insuficiencia cardiaca | spa |
| dc.subject | Síndrome cardio-hepático | spa |
| dc.subject | Fracción de eyección reducida | spa |
| dc.subject | Biomarcadores hepáticos | spa |
| dc.subject | ProBNP | spa |
| dc.subject | Daño hepático | spa |
| dc.subject | Evolución clínica | spa |
| dc.subject.keywords | Heart failure | eng |
| dc.subject.keywords | Cardio-hepatic syndrome | eng |
| dc.subject.keywords | Reduced ejection fraction | eng |
| dc.subject.keywords | Hepatic biomarkers | eng |
| dc.subject.keywords | ProBNP | eng |
| dc.subject.keywords | Liver damage | eng |
| dc.subject.keywords | Clinical outcomes | eng |
| dc.title | Caracterización del síndrome cardio-hepático en pacientes con insuficiencia cardiaca agudizada entre el 2022 y 2023 | spa |
| dc.type.driver | info:eu-repo/semantics/other | |
| dc.type.spa | Otros | |
| dcterms.references | Malik A, Brito D, Vaqar S, Chhabra L. Congestive Heart Failure [Internet]. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28785469 | eng |
| dcterms.references | Møller S, Bernardi M. Interactions of the heart and the liver. Eur Heart J. 2013 Sep;34(36):2804–11. | eng |
| dcterms.references | Saner FH, Heuer M, Meyer M, Canbay A, Sotiropoulos GC, Radtke A, et al. When the heart kills the liver: acute liver failure in congestive heart failure. Eur J Med Res. 2009;14(12):541–6. | eng |
| dcterms.references | Xanthopoulos A, Starling RC, Kitai T, Triposkiadis F. Heart Failure and Liver Disease. JACC Hear Fail. 2019 Feb;7(2):87–97. | eng |
| dcterms.references | Bejarano Ramírez DF, Carrasquilla Gutiérrez G, Porras Ramírez A, Vera Torres A. Prevalence of liver disease in Colombia between 2009 and 2016. JGH open an open access J Gastroenterol Hepatol. 2020 Aug;4(4):603–10. | eng |
| dcterms.references | Chaparro-Narváez P, Ordóñez-Monak IA, Trujillo N, Castañeda-Orjuela CA, Arroyave I. Educational inequalities in heart failure mortality and the cycles of the internal armed conflict in Colombia: An observational panel study of ecological data, 1999–2017. Heliyon. 2023 Feb;9(2):e13050. | eng |
| dcterms.references | Jimenez M, Arroyave I. How Educational Inequalities in Cardiovascular Mortality Evolve While Healthcare Insurance Coverage Grows: Colombia, 1998 to 2015. Value Heal Reg Issues. 2020 Dec;23:112–21. | eng |
| dcterms.references | Muñoz-Mejía OA, Sierra-Vargas EC, Zapata-Cárdenas A, Isaza-Montoya M, Muñoz-Cifuentes MA, Sánchez-Echavarría JD, et al. Caracterización sociodemográfica y clínica de una población con falla cardíaca aguda: cohorte MED-ICA. Rev Colomb Cardiol. 2018 May;25(3):200–8. | spa |
| dcterms.references | Castiglione V, Aimo A, Vergaro G, Saccaro L, Passino C, Emdin M. Biomarkers for the diagnosis and management of heart failure. Heart Fail Rev. 2022 Mar;27(2):625–43. | eng |
| dcterms.references | Al-Sadawi M, Saad M, Ayyadurai P, Shah NN, Bhandari M, Vittorio TJ. Biomarkers in Acute Heart Failure Syndromes: An Update. Curr Cardiol Rev. 2022 May;18(3). | eng |
| dcterms.references | Javed N, El-Far M, Vittorio TJ. Clinical markers in heart failure: a narrative review. J Int Med Res. 2024 May;52(5):3000605241254330. | eng |
| dcterms.references | Wettersten N. Biomarkers in Acute Heart Failure: Diagnosis, Prognosis, and Treatment. Int J Hear Fail. 2021 Apr;3(2):81–105. | eng |
| dcterms.references | Rodriguez Ziccardi M, Pendela VS, Singhal M. Cardiac Cirrhosis. StatPearls. 2024. | eng |
| dcterms.references | Nayak A, Hicks AJ, Morris AA. Understanding the Complexity of Heart Failure Risk and Treatment in Black Patients. Circ Heart Fail. 2020 Aug;13(8):e007264. | eng |
| dcterms.references | Samsky MD, Dunning A, DeVore AD, Schulte PJ, Starling RC, Wilson Tang WH, et al. Liver function tests in patients with acute heart failure and associated outcomes: insights from <scp>ASCEND‐HF</scp>. Eur J Heart Fail. 2016 Apr;18(4):424–32. | eng |
| dcterms.references | Li Y, Sun X-L, Qiu H, Qin J, Li C-S, Yu X-Z, et al. Long-term outcomes and independent predictors of mortality in patients presenting to emergency departments with acute heart failure in Beijing: a multicenter cohort study with a 5-year follow-up. Chin Med J (Engl). 2021 Jun;134(15):1803–11. | eng |
| dcterms.references | Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May;145(18). | eng |
| dcterms.references | Brankovic M, Lee P, Pyrsopoulos N, Klapholz M. Cardiac Syndromes in Liver Disease: A Clinical Conundrum. J Clin Transl Hepatol. 2023 Aug;11(4):975–86. | eng |
| dcterms.references | Poelzl G, Auer J. Cardiohepatic syndrome. Curr Heart Fail Rep. 2015 Feb;12(1):68–78. | eng |
| dcterms.references | Dimitroglou Y, Mani I, Dourakis S. The cardiohepatic syndrome. Arch Hell Med. 2019;36:151–65. | eng |
| dcterms.references | Alvarez AM, Mukherjee D. Liver abnormalities in cardiac diseases and heart failure. Int J Angiol. 2011 Sep;20(3):135–42. | eng |
| dcterms.references | Laribi S, Mebazaa A. Cardiohepatic Syndrome: Liver Injury in Decompensated Heart Failure. Curr Heart Fail Rep. 2014 Sep;11(3):236–40. | eng |
| dcterms.references | Arrigo M, Jessup M, Mullens W, Reza N, Shah AM, Sliwa K, et al. Acute heart failure. Nat Rev Dis Prim. 2020 Mar;6(1):16. | eng |
| dcterms.references | Giallourakis CC. Liver complications in patients with congestive heart failure. Gastroenterol Hepatol (N Y). 2013 Apr;9(4):244–6. | eng |
| dcterms.references | El Hadi H, Di Vincenzo A, Vettor R, Rossato M. Relationship between Heart Disease and Liver Disease: A Two-Way Street. Cells. 2020 Feb;9(3). | eng |
| dcterms.references | Rafaqat S, Radoman Vujacic I, Behnoush AH, Sharif S, Klisic A. Role of Cardiac Biomarkers in Hepatic Disorders: A Literature Review. Metab Syndr Relat Disord. 2024 May;22(4):251–62. | eng |
| dcterms.references | Aspromonte N, Fumarulo I, Petrucci L, Biferali B, Liguori A, Gasbarrini A, et al. The Liver in Heart Failure: From Biomarkers to Clinical Risk. Int J Mol Sci. 2023 Oct;24(21). | eng |
| dcterms.references | Sungur MA, Sungur A, Zencirci AE. The Relationship between the Presence of Cardiohepatic Syndrome and Mortality in Heart Failure with Reduced Ejection Fraction. Turk Kardiyol Dern Ars. 2023 Oct; | eng |
| dcterms.references | Golla MSG, Hajouli S, Ludhwani D. Heart Failure and Ejection Fraction. StatPearls. 2024. | eng |
| dcterms.references | Hidalgo H, Suarez B, Belaunde A, Cardoso A. Síndrome cardiohepático en pacientes con insuficiencia cardiaca descompensada en el Hospital Militar Central “Dr. Carlos J. Finlay.” Acta Medica Cordoba. 2021;22(4):e244. | eng |
| dcterms.references | Okano T, Motoki H, Minamisawa M, Kimura K, Kanai M, Yoshie K, et al. Cardio-renal and cardio-hepatic interactions predict cardiovascular events in elderly patients with heart failure. PLoS One. 2020;15(10):e0241003. | eng |
| dcterms.references | Héctor De La Torre-Hasbum GT-G. Prevalencia de hipertensión arterial en pacientes residentes en la ciudad de Santa Marta (Colombia), atendidos en el Hospital Universitario Fernando Troconis. Duazary. 2019;16(2):124–33. | spa |
| dcterms.references | Vallejo Mesa E, Rodríguez Alvira FJ. Epidemiología de la retinopatía diabética y su relación con la diabetes. Rev Colomb Endocrinol Diabetes Metab. 2017 Mar;3(1):12–5. | spa |
| dcterms.references | Aschner P. Epidemiología de la diabetes en Colombia. Av en Diabetol. 2010 Apr;26(2):95–100. | spa |
| dcterms.references | García-Peña ÁA, Ospina D, Rico J, Fernández-Ávila DG, Muñoz-Velandia Ó, Suárez-Obando F. Prevalencia de hipertensión arterial en Colombia según información del Sistema Integral de Información de la Protección Social (SISPRO). Rev Colomb Cardiol. 2022 Feb;29(1). | spa |
| dcterms.references | Schrier RW. Use of Diuretics in Heart Failure and Cirrhosis. Semin Nephrol. 2011 Nov;31(6):503–12. | eng |
| dcterms.references | Tapper EB. Use of Angiotensin-Converting Enzyme Inhibitors in Patients With Liver Disease. Gastroenterol Hepatol (N Y). 2023 Jan;19(1):65–7. | eng |
| dcterms.references | Rodrigues SG, Mendoza YP, Bosch J. Beta-blockers in cirrhosis: Evidence-based indications and limitations. JHEP reports Innov Hepatol. 2020 Feb;2(1):100063. | eng |
| dcterms.references | Ge PS, Runyon BA. The changing role of beta-blocker therapy in patients with cirrhosis. J Hepatol. 2014;60(3):643–53. | eng |
| dcterms.references | Karaca O. Focusing on Cardio-Hepatic Syndrome in Heart Failure and Cardiovascular Interventions: Time to Update the Prognostic Risk Scores? Turk Kardiyol Dern Arsivi-Archives Turkish Soc Cardiol. 2023;304–5. | eng |
| dcterms.references | Kurmani S, Squire I. Acute Heart Failure: Definition, Classification and Epidemiology. Curr Heart Fail Rep. 2017 Oct;14(5):385–92. | eng |
| dcterms.references | Bhutta BS, Alghoula F, Berim I. Hypoxia. StatPearls. 2024. | eng |
| dcterms.references | Dayer N, Ltaief Z, Liaudet L, Lechartier B, Aubert J-D, Yerly P. Pressure Overload and Right Ventricular Failure: From Pathophysiology to Treatment. J Clin Med. 2023 Jul;12(14). | eng |
| dcterms.references | Mechanic OJ, Gavin M, Grossman SA. Acute Myocardial Infarction. StatPearls. 2024. | eng |
| dcterms.references | Masenga SK, Kirabo A. Hypertensive heart disease: risk factors, complications and mechanisms. Front Cardiovasc Med. 2023;10:1205475. | eng |
| dcterms.references | Ciobanu AO, Gherasim L. Ischemic Hepatitis - Intercorrelated Pathology. Maedica (Buchar). 2018 Mar;13(1):5–11. | eng |
| dcterms.references | Bunte S, Walz R, Merkel J, Torregroza C, Roth S, Lurati Buse G, et al. Bilirubin-A Possible Prognostic Mortality Marker for Patients with ECLS. J Clin Med. 2020 Jun;9(6). | eng |
| dcterms.references | WROBLEWSKI F, LADUE JS. Serum glutamic pyruvic transaminase in cardiac with hepatic disease. Proc Soc Exp Biol Med. 1956 Apr;91(4):569–71. | eng |
| dcterms.references | Ghenu MI, Dragoş D, Manea MM, Ionescu D, Negreanu L. Pathophysiology of sepsis-induced cholestasis: A review. JGH open an open access J Gastroenterol Hepatol. 2022 Jun;6(6):378–87. | eng |
| dcterms.references | Park J, Kim G, Kim H, Lee J, Jin SM, Kim JH. The associations between changes in hepatic steatosis and heart failure and mortality: a nationwide cohort study. Cardiovasc Diabetol. 2022;21(1):1–11. | eng |
| dcterms.references | Bannon L, Merdler I, Bar N, Lupu L, Banai S, Jacob G, et al. The Cardio-Hepatic Relation in STEMI. J Pers Med. 2021 Nov;11(12). | eng |
| oaire.version | info:eu-repo/semantics/acceptedVersion | |
| sb.programa | Especialización en Medicina Interna | spa |
| sb.sede | Sede Barranquilla | spa |
Archivos
Bloque de licencias
1 - 1 de 1
No hay miniatura disponible
- Nombre:
- license.txt
- Tamaño:
- 2.93 KB
- Formato:
- Item-specific license agreed upon to submission
- Descripción: