Decreasing Risk of Life Saving TIPS Procedure in Liver Failure Patients

Principal Investigator: Lisa B. VanWagner MD, MS, Assistant Professor of Medicine (Gastroenterology and Hepatology) and Preventive Medicine (Epidemiology) Cirrhosis of the liver affects millions of Americans and leads to increased and life-threatening pressure in the blood vessels of the liver. One of the core treatments for this potentially deadly complication is a procedure called “TIPS.” While effectively reducing pressure in the liver, TIPS can result in heart failure in at least 20% of patients. The ability to identify patients at risk for cardiac dysfunction would allow clinicians to put into place targeted prevention strategies before and after TIPS. With that aim in mind, the VanWagner team is evaluating new imaging methods of the heart and liver to better understand how TIPS alters liver hemodynamics and changes cardiovascular structure, function, and flow in patients with cirrhosis undergoing TIPS. Study findings could lead to interventions to prevent the development of heart failure in this at-risk patient population, so more patients facing liver cirrhosis could safely receive the TIPS treatment while reducing the associated risk of heart...

Blood Pressure Measurement Methods in Liver Transplant Patients

Principal Investigator: Lisa B. VanWagner, MD Liver transplantation extends the lives of many patients with liver failure. Yet, one in three recipients will experience a heart disease event after liver transplant surgery due to the effects of immunosuppression causing a high prevalence of cardiovascular risk factors, such as high blood pressure (BP). Decreasing hypertension in these patients could help improve their outcomes. While there are different methods for detecting high BP, some are better than others. Home monitors and portable/wearable 24-hour monitoring devices often best reveal how blood pressure readings relate to daily activities and sleep and provide keener insights into patients’ true blood pressure levels than measurements taken in the clinic. Dr. VanWagner’s study will involve measuring blood pressure over time in 50 Northwestern liver transplant recipients. Her team will use the office, home, and 24-hour blood pressure measurement approaches to enable interventions to lower blood pressure and prevent dangerous heart disease events after transplant...

Impact of an artificial liver shunt procedure for the treatment of high pressure in the vein that carries blood from the digestive organs to the liver on the function of the heart

Principal Investigator: Lisa B. VanWagner, MD The portal vein carries blood from digestive organs to the liver. Portal hypertension occurs when pressure increases within this vein due to blockage in blood flow through the liver. Cirrhosis, or scarring, of the liver is the most common cause.  This condition often results in fluid build-up in the abdomen and bleeding from veins in the esophagus that can impair quality of life and even lead to death due to intestinal bleeding or infection. An artificial shunt procedure known as TIPS (transjugular intrahepatic portosystemic shunt) helps reduce portal hypertension. It works by connecting two veins: the portal vein that carries blood from the digestive organs to the liver and the hepatic vein that carries blood from the liver to the right part of the heart. While the lifesaving procedure may cause heart failure in some patients because of increased blood flow directly to the heart, others experience improvement in heart function. However, predicting outcomes for these patients is currently unknown. Dr. VanWagner’s study aims to better understand changes in heart function after a TIPS procedure to better intervene and prevent heart failure in these at-risk...