{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:00:46Z","timestamp":1792839646591,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Transjugular intrahepatic portosystemic shunt (TIPS) is now a standard for the treatment of portal hypertension\u2013related complications. After the TIPS procedure, incidence and risk factors of cardiac decompensation are poorly known. The main objectives were to measure the incidence of the onset of cardiac decompensation after TIPS and identify the predictive factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>\n                      All patients with cirrhosis treated with TIPS between May 2011 and June 2016 were considered for inclusion. They received a cardiac assessment by standard biological parameters, transthoracic echocardiography, and right heart catheterization. Patients were followed for 1 year after TIPS insertion. The main endpoint was the incidence of cardiac decompensation requiring hospitalization. One hundred seventy\u2010four patients were treated by TIPS during the period. One hundred patients who underwent a complete cardiac evaluation were included. A cardiac decompensation occurred in 20% of the patients. The parameters associated with the occurrence of severe cardiac decompensation were a prolonged QT interval corrected (462 vs. 443 ms;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.05), an elevated pre\u2010TIPS brain natriuretic peptide (BNP) or N\u2010terminal pro\u2010brain natriuretic peptide (NT\u2010proBNP) level, an elevated E\/A ratio (1.5 vs. 1.0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.001) and E\/e\u2032 ratio (11 vs. 7;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and a left atrial dilatation (40 vs. 29\u00a0mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.011). The presence of aortic stenosis was also associated with cardiac decompensation. A level of BNP &lt;40\u00a0pg\/mL and NT\u2010proBNP &lt;125\u00a0pg\/mL allowed identifying patients without risk of cardiac decompensation. Additionally, absence of diastolic dysfunction criteria at echocardiography ruled out the risk of further cardiac decompensation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospitalization for cardiac decompensation is observed in 20% of patients in the year after TIPS insertion. Combining BNP or NT\u2010proBNP levels and echocardiographic parameters should help improve patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.30934","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T05:39:22Z","timestamp":1568266762000},"page":"1928-1941","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":128,"title":["A Prospective Study Identifying Predictive Factors of Cardiac Decompensation After Transjugular Intrahepatic Portosystemic Shunt: The Toulouse Algorithm"],"prefix":"10.1097","volume":"70","author":[{"given":"Chlo\u00e9","family":"Billey","sequence":"first","affiliation":[{"name":"Liver Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Billet","sequence":"additional","affiliation":[{"name":"Cardiology Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Ang\u00e8le","family":"Robic","sequence":"additional","affiliation":[{"name":"Liver Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cognet","sequence":"additional","affiliation":[{"name":"Cardiology Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2782-7556","authenticated-orcid":false,"given":"Maeva","family":"Guillaume","sequence":"additional","affiliation":[{"name":"Liver Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Pierre","family":"Vinel","sequence":"additional","affiliation":[{"name":"Liver Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Marie","family":"P\u00e9ron","sequence":"additional","affiliation":[{"name":"Liver Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Lairez","sequence":"additional","affiliation":[{"name":"Cardiology Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet Institute,Toulouse,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Bureau","sequence":"additional","affiliation":[{"name":"Liver Unit Toulouse Hospital,Paul Sabatier Universitary and Cardiomet 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