Detection of hepatopulmonary syndrome in patients with liver cirrhosis using 3D contrast echocardiography

Abstract Background and study aims Hepatopulmonary syndrome (HPS) is characterised by the triad of advanced liver disease, arterial hypoxaemia and intrapulmonary vascular dilatation (IPVD). The present study aimed to evaluate HPS in patients with liver cirrhosis and the role of three-dimensional (3D) contrast echocardiography in the detection of this syndrome. Patients and methods A total of 78 chronic liver disease patients aged 42 ± 11 years fulfilled the criteria for this study and were subjected to clinical examination, laboratory investigations, arterial blood gases measurement, pulmonary function tests, upper gastrointestinal endoscopy, 3D contrast echocardiography and computed tomography (CT) pulmonary angiography. Results According to 3D contrast echocardiography results, we divided the patients into a positive group ( n  = 26) in which patients showed a delayed appearance of contrast in left heart chambers and a negative group ( n  = 52). Among 26 patients of the positive group, nine had hypoxaemia (partial pressure of oxygen (PaO 2 ) Conclusion Cyanosis, clubbing and platypnoea-orthodeoxia are suggestive indicators of HPS, which can be easily detected by 3D contrast echocardiography which can replace the trans-oesophageal echocardiogram (TEE) in cirrhotic patients.