Lung Diffusion Capacity in Early Cirrhosis: Is Lung Diffusion Capacity a Predictor of Esophageal Varices and Ascites?

Abstract

Varices and ascites are clinical manifestations of hyperdynamic circulation syndrome originating from increased nitric oxide in cirrhosis. Research was conducted in order to find any correlation between lung diffusion capacity and the presence of varices and ascites in cirrhosis. The study was conducted on a total of 120 subjects. Tests for pulmonary function, including carbon monoxide diffusing capacity (DLCO) and fractional exhaled nitric oxide (F(E)NO), were performed. DLCO/alveolar ventilation (VA) values were lower in cirrhosis and chronic liver disease groups than in the control group (3.79 vs. 4.5 vs. 5.1 ml/mmHg/min, p < 0.001). DLCO/VA showed a negative correlation with the Child score and the MELD score (r = -0.3 vs. r = -0.41). In patients with varices, the DLCO/VA value was 3.75 ml/mmHg/min, which was lower than the 4.12 ml/mmHg/min observed in patients without varices (p = 0.029). F(E)NO levels were higher in the chronic liver disease and liver cirrhosis groups than in the control group. F(E)NO and DLCO showed a negative correlation (r = -0.25, p = 0.006). The frequency of significant varix and decompensation were higher in the high FeNO group. Lung diffusion capacity decreased according to the disease's severity in early cirrhosis, and showed a good correlation with esophageal varices and ascites.