Cardiovascular risk assessment and predictors of cardiac decompensation after transjugular intrahepatic portosystemic shunt in patients with cirrhosis

Table 1 Studies on predictors of cardiac decompensation in patients with cirrhosis post-transjugular intrahepatic portosystemic shunt study design data

Ref.	Year	Type	Design	Setting	Population	Sample (n)	Predictors	Outcomes	Follow up (months)
Ali et al[10]	2022	J	Retrospective cohort	Single centre (United States)	Patients with cirrhosis for TIPS	107	TTE: RA size, LV dimensions, PASP	Significant HF, mortality	3
Alla et al[40]	2021	CA	Retrospective cohort	Single centre (India)	Patients with cirrhosis for TIPS	164	TTE: RAP, EF, E/e’; HVPG; NT-proBNP; MELD; CTP	Significant HF, mortality	24
Billey et al[9]	2019	J	Prospective cohort	Single centre (France)	Patients with cirrhosis for TIPS	100	TTE: E/A > 1.5, E/e’ > 10, LAVI > 34 mL/m2, AS; BNP > 40 pg/mL; NT-proBNP > 125 pg/mL; QTc > 440 milliseconds	Significant HF	12
Filì et al[43]	2015	J	Prospective physiological	Single centre (Italy)	Patients with cirrhosis for TIPS	15	TTE: LV dimensions, IVS, LVEF, LAD, E/A, DT, PASP; RHC: PASP, mPAP, pADP, PCWP, TPG, CO, PVS, SVR; NT-proBNP; QTc > 440 milliseconds	Haemodynamic changes, significant HF	1
Laurenzano et al[39]	2024	J	Retrospective cohort	Dual centre (United States)	Patients with cirrhosis for TIPS	360	TTE: LAVI, E/e’, TR max, septal e, lateral e, LVEF; Intraprocedural RA pressure	Significant HF, hospitalisation, mortality	24
Luo et al[44]	2024	CA	Retrospective cohort	Single centre (China)	Patients with cirrhosis for TIPS	140	TTE: LVEF, E/A, LAVI, Septal e’, lateral e’, E/e’, pro-BNP	Significant HF, mortality	6
Modha et al[45]	2018	J	Retrospective case-control	Single centre (United States)	Patients with cirrhosis for TIPS	481	Age; RA pressure, portal vein pressure	Significant HF, mortality	1
Nguyen et al[47]	2022	CA	Retrospective cohort	Single centre (United States)	Patients with cirrhosis for TIPS	249	MELD-Na; PMHx: IHD, CVA/TIA, HFpEF	Significant HF	6
Schneider et al[11]	2023	J	Retrospective cohort	Single centre (Germany)	Patients with cirrhosis for TIPS	234	DD (ASE/EACVI), pathological E/A, HanDeCT algorithm	Significant HF	12
Vanderschueren et al[41]	2024	J	Retrospective cohort	Single centre (Belgium)	Patients with cirrhosis for TIPS	106	TTE: LAVI; Age; Albumin; NT-proBNP; Toulouse algorithm	Significant HF, mortality	12
Venner et al[46]	2025	J	Retrospective cohort	Single centre (Netherlands)	Patients with cirrhosis for TIPS	52	H2FPEF score, LA strain, HDF, QTc, E/e’ ratio, RWT	Significant HF	6
Debernardi Venon et al[49]	2021	J	Retrospective cohort	Single centre (Italy)	Patients with cirrhosis for TIPS	63	LV diastolic dimensions, EACI/ASE DD: LA diameter, LVEF, TAPSE, E/A ratio, e’, mPAP, CVP, NT-proBNP, PRA	LV DD incidence, TIPS response, mortality	12
Wade et al[48]	2021	CA	Retrospective cohort	Single centre (United States)	Patients with cirrhosis for TIPS	36	MELD-Na, bilirubin, INR, TTE parameters (atrial dimensions and pressures)	Significant HF	12

¹882 patients met inclusion criteria, only 48 were included in the final analysis.

J: Journal article; CA: Conference abstract; TIPS: Transjugular intrahepatic portosystemic shunt; TTE: Transthoracic echocardiography; RA: Right atrial; LV: Left ventricular; PASP: Pulmonary artery systolic pressure; RAP: Right atrial pressure; HF: Heart failure; EF: Ejection fraction; E/e’: Estimate of left ventricular filling pressures; HVPG: Hepatic venous pressure gradient; NT-proBNP: N-terminal pro-B-type natriuretic peptide; MELD: Model for end-stage liver disease; CTP: Child-Turcotte-Pugh score; E/A: Early to late mitral inflow velocity ratio; LAVI: Left atrial volume index; AS: Aortic stenosis; QTc: Corrected QT interval (> 440 milliseconds considered prolonged); IVS: Interventricular septum; LVEF: Left ventricular ejection fraction; LAD: Left atrial diameter; DT: Deceleration time; RHC: Right heart catheterisation; mPAP: Mean pulmonary artery pressure; pADP: Pulmonary artery diastolic pressure; PCWP: Pulmonary capillary wedge pressure; TPG: Transpulmonary gradient; CO: Cardiac output; PVS: Pulmonary vascular resistance; SVR: Systemic vascular resistance; MELD-Na: Model for end-stage liver disease incorporating serum sodium; PMHx: Past medical history; IHD: Ischaemic heart disease; CVA/TIA: Cerebrovascular accident/transient ischaemic attack; HFpEF: Heart failure with preserved ejection fraction; DD: Diastolic dysfunction; ASE/EACVI: American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines; HanDeCT: Diagnostic algorithm for haemodynamic decompensation post-transjugular intrahepatic portosystemic shunt; H₂FPEF: Scoring tool to predict heart failure with preserved ejection fraction; RWT: Relative wall thickness; PRA: plasma renin activity; LA strain: Measure of left atrial deformation.