Cardiovascular magnetic resonance reveals stable myocardial tissue characteristics despite cardiac remodelling after transjugular intrahepatic portosystemic shunt in liver cirrhosis

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ID: 324937
2026
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Abstract
Abstract Aims Transjugular intrahepatic portosystemic shunt (TIPS) reduces portal hypertension in liver cirrhosis but acutely increases cardiac preload. The present study aimed to prospectively assess changes in cardiac function, remodelling, and myocardial tissue characteristics after TIPS using cardiovascular magnetic resonance (CMR). Methods and results Of the 45 screened patients with advanced liver cirrhosis, 23 patients [median (IQR) age 65 (56–69) years, 70% male, 87% Child–Pugh class B, MELD score 14 (12–20)] were prospectively included and underwent multiparametric CMR before TIPS implantation (CMR-1), as well as follow-up imaging after 3 (2–4) days (CMR-2, n = 20) and 100 (87–122) days (CMR-3, n = 10). Biventricular end-diastolic volumes increased significantly from baseline to the final follow-up (CMR-3) [left ventricle (LV) +27.2 (20.8–38.6) mL/m2; right ventricle (RV) +26.1 (18.2–38.0) mL/m2; both P < 0.001], accompanied by increased stroke volumes [LV +7.2 (3.6–15.7) mL/m2, RV +9.8 (2.3–15.4) mL/m2; both P < 0.001]. LV mass increased from 32 (30–37) g/m2 to 47 (45–52) g/m2 (P < 0.001). Although extracellular volume (ECV) fraction remained unchanged [27 (23–28) % vs. 25 (23–29) %; P = 0.06], ECV mass increased from 17.1 (14.0–21.8) g to 25.4 (20.7–27.4) g (P < 0.001), reflecting the concomitant increase in LV mass. Myocardial tissue characterization revealed no significant changes in native T1 or T2 values during follow-up (all P > 0.05). Conclusion TIPS implantation induces progressive biventricular dilatation, increased stroke volume, and eccentric remodelling. Despite these marked structural adaptations, myocardial tissue characteristics remained largely unchanged during short- and mid-term follow-up, suggesting predominantly preload-driven cardiac remodelling.
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Authors Leonora Zange, Jan Gröschel, Hebatalla Abdalla, Leonhard Grassow, Frank Kolligs, Christine Schürmann, Jeanette Schulz‐Menger
Journal European Heart Journal - Cardiovascular Imaging
Year 2026
DOI
10.1093/ehjci/jeag207
URL
https://doi.org/10.1093/ehjci/jeag207
Keywords Keywords not found

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