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AIM:To evaluate the frequency,clinical andparaclinical features of hepatopulmonary syndrome(HPS)and to determine their predictive values in di-agnosis of this syndrome in patients in Iran.METHODS:Fifty four cirrhotic patients underwentcontrast enhanced echocardiography to detect intra-pulmonary and intracardiac shunts by two cardiolo-gists.Arterial blood oxygen,O_2 gradient(A-a)andorthodoxy were measured by arterial blood gas(ABG)test.The patients positive for diagnostic criteria ofHPS were defined as clinical HPS cases and thosemanifesting the intrapulmonary arterial dilation but noother criteria(arterial blood hypoxemia)were definedas IHPS cases.HPS frequency,sensitivity,positive andnegative predictive values of clinical and paraclinicalfeatures were studied.RESULTS:Ten(18.5%)and seven(13%)cases hadclinical and subclinical HPS,respectively.The mostcommon etiology was hepatitis B.Dyspnea(100%)and cyanosis(90%)were the most prevalent clinicalfeatures.Dyspnea and clubbing were the most sen-sitive and specific clinical features respectively.Nosignificant relationship was found between HPS andsplenomegaly,ascites,edema,jaundice,oliguria,andcollateral veins.HPS was more prevalent in hepatitisB.PaO_2<70 and arterial-alveolar gradient had thehighest sensitivity in HPS patients.Orthodoxy speci- ficity was 100%CONCLUSION:Clubbing with positive predictive val-ue(PPV)of 75% and dyspnea with negative predic-tive value(NPV)of 75% are the best clinical factorsin diagnosis of HPS syndrome.PaO_2<70 and P(A-a)O_2>30 and their sum,are the most valuable negativeand positive predictive values in HPS patients.
AIM: To evaluate the frequency, clinical andparaclimental features of hepatopulmonary syndrome (HPS) and determine their predictive values in di-agnosis of this syndrome in patients in Iran. METHODS: Fifty four cirrhotic patients underwentcontrast enhanced echocardiography to detect intra-pulmonary and intracardiac shunts by two cardiolo-gists. Arterial blood oxygen, O_2 gradient (Aa) andorthodoxy were measured by arterial blood gas (ABG) test.The patients positive for diagnostic criteria of HPS were defined as clinical HPS cases and thosemanifesting the intrapulmonary arterial dilation but noother criteria Results: Fifteen cases of HPS, respectively, had defined as IHC cases.HPS frequency, sensitivity, positive andnegative predictive values of clinical and paraclinicalfeatures were studied.RESULTS: Ten (18.5%) and seven (13%) cases hadclinical and subclinical HPS, respectively.The mostcommon etiology was hepatitis B. Dyspnea (100%) and cyanosis (90%) were the most prevalent clinical features. Dyspnea and clubbing were the most sen-sitive and specific clinical features respectively. Nonignificant relationship was found between HPS and complex nomegaly, ascites, edema, jaundice, oliguria, and collateral veins. HP was more prevalent in hepatitisB.PaO_2 <70 and arterial-alveolar gradient had the highest sensitivity in HPS patients. Orthodoxy speci- ficity was 100% CONCLUSION: Clubbing with positive predictive val-ue (PPV) of 75% and dyspnea with negative predictive value (NPV) of 75% are the best clinical factors in diagnosis of HPS syndrome. PaO_2 <70 and P (Aa) O_2> 30 and their sum, are the most valuable negative and positive predictive values in HPS patients.