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 23 November 2017

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News

Upper-gastrointestinal changes in patients with heart failure

The presence and the severity of duodenopathy has been found to be significantly associated with the increasing severity of features of congestive heart failure, reports the most recent issue of Gastrointestinal Endoscopy.

News image

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Congestive heart failure results in an increase in systemic venous pressure that is transmitted to the inferior vena cava and to the hepatic veins.

This can cause GI vascular and mucosal congestion.

Dr Kochhar and colleagues from India undertook a study in order to define upper-GI mucosal changes in patients with congestive heart failure.

The researchers oversaw upper endoscopy procedures for a total of 57 patients with congestive heart failure presenting with GI symptoms.

The investigators performed echocardiography in all patients to determine the ejection fraction and the degree of tricuspid regurgitation.

In addition, clinicians performed transabdominal ultrasound to measure the diameters of the hepatic veins, the inferior vena cava, and the portal vein.

The researchers then compared the presence and the severity of gastropathy and duodenopathy with the parameters relating to severity of cardiac failure.

The researchers found gastric mucosal changes in 88%, duodenal mucosal changes in 54%, and esophageal mucosal changes in none, out of the 57 patients studied.

The research team noted various gastric mucosal changes: mosaic-like pattern (n=50), punctate spots (n=34), thickened folds (n=5), watermelon stomach (n=3), and telangiectasia (n=10).

Severity of duodenopathy showed a high degree of positive correlation with the presence and the severity of gastropathy
Gastrointestinal Endoscopy

In addition, the team observed duodenal mucosal changes: mosaic-like pattern (n=29), thickened folds (n=8), and telangiectasia (n=2).

The researchers found that upper-GI symptoms were associated with gastropathy and duodenopathy.

The presence and the severity of duodenopathy showed a high degree of positive correlation with the presence and the severity of gastropathy.

In addition, the researchers noted that patients with gastropathy and duodenopathy had higher mean inferior vena cava and hepatic vein diameters than those without gastropathy and duodenopathy.

The researchers commented, "The severity of duodenopathy but not that of gastropathy was significantly associated with increasing severity of tricuspid regurgitation, larger portal vein diameter, and lower ejection fraction."

"Among patients with congestive cardiac failure with GI symptoms, changes of congestive gastropathy are evident in 88% and duodenopathy in 54%."

Dr Kochhar concluded, "The presence and the severity of duodenopathy was significantly associated with increasing severity of features of congestive heart failure."

Gastrointestinal Endoscopy; 2004: 60 (6): 887
23 December 2004

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