Clinical Trials Study
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World J Gastroenterol. Aug 14, 2014; 20(30): 10564-10569
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10564
Chronic permanent hypoxemia predisposes to mild elevation of liver stiffness
Mohamed Tahiri, Abdenasser Drighil, Yasmine Jalal, Dounia Ghellab, Wafaa Hliwa, Haddad Fouad, Wafaa Badre, Ahmad Bellabah, Rachida Habbal, Rhimou Alaoui
Mohamed Tahiri, Yasmine Jalal, Wafaa Hliwa, Haddad Fouad, Wafaa Badre, Ahmad Bellabah, Rhimou Alaoui, Department of Gastroenterology, Ibn Rochd University Hospital Center of Casablanca, Casablanca 20170, Morocco
Abdenasser Drighil, Dounia Ghellab, Rachida Habal, Department of Cardiology, Ibn Rochd University Hospital Center of Casablanca, Casablanca 20170, Morocco
Author contributions: Tahiri M designed the research and wrote the paper; Jalal Y, Hliwa W, Fouad H, Badre W, Bellabah A and Alaoui R performed the research; Drighil A, Ghellab D and Habal R analyzed the data.
Correspondence to: Dr. Tahiri Mohame, PhD, Department of Gastroenterology, Ibn Rochd University Hospital Center of Casablanca, 187, Lotissement Madaronna, Sidi Maârouf, Casablanca 20170, Morocco. docteurtahirimohamed@yahoo.fr
Telephone: +212-77561214 Fax: +212-73618211
Received: August 22, 2013
Revised: October 31, 2013
Accepted: January 6, 2014
Published online: August 14, 2014
Abstract

AIM: To evaluate the impact of long term permanent hypoxemia noticed in patients with non operated congenital cyanogenic cyanotic cardiopathy on liver stiffness.

METHODS: We included ten adult patients with non operated inoperate cyanotic cardiopathy and ten matched patients for age and gender admitted to the gastroenterology department for proctologic diseases; Clinical and laboratory data were collected [age, gender, body mass index, oxygen saturation, glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), glycemia and cholesterol]. Measurement of hepatic stiffness by transient elastography was carried out in all patients using the Fibroscan device. All patients underwent an echocardiography to eliminate congestive heart failure.

RESULTS: Among the patients with cyanotic cardiopathy, median liver stiffness 5.9 ± 1.3 kPa was greater than control group (4.7 ± 0.4 kPa) (P = 0.008). Median levels of GOT, GPT, gamma-glutamyltransferase, glycemia and cholesterol were comparable in cardiopathy and control group. In regression analysis including age, gender, body mass index, oxygen saturation, GOT, GPT, glycemia, cholesterol showed that only oxygen saturation was related to liver stiffness (r = -0.63 P = 0.002).

CONCLUSION: Chronic permanent hypoxemia can induce mild increase of liver stiffness, but further studies are needed to explore the histological aspects of liver injury induced by chronic permanent hypoxemia.

Keywords: Liver, Cardiopathy, Hypoxemia, Stiffness, Cyanotic

Core tip: Our study is the first one to be carried out in humans and to evaluate the long term effect of hypoxemia on liver stiffness. The clinical model is provided by non operated adult patients with cyanotic cardiopathy. Heart failure, that can overestimate liver stiffness, is eliminated by echocardiography in all patients. The results show that long term hypoxemia leads to only mild liver stiffness elevation.