Echocardiographic assessment of the left ventricular diastolic function in patients with non-alcoholic liver cirrhosis

• Published in: Cor et vasa (English ed.) Vol. 59; no. 6; pp. e540 - e545
• Main Authors: Farouk, Heba, Al-Maimoony, Taha, Nasr, Abdo, El-Serafy, Magdy, Abdel-Ghany, Mohamed
• Format: Journal Article
• Language: English
• Published: Elsevier Urban & Partner Sp. z o.o 01.12.2017
• Subjects: Cardiac complications; Cardiovascular; Left ventricular diastolic function; Left ventricular filling pressure; Liver cirrhosis; Liver transplantation; Mitral indexes; Left ventricular filling pressure; Left ventricular diastolic function; Mitral indexes; Cardiac complications; Liver cirrhosis; Liver transplantation
• ISSN: 0010-8650; 1803-7712
• DOI: 10.1016/j.crvasa.2016.12.011

Abstract Aim To assess the left ventricular diastolic function in patients with non-alcoholic liver cirrhosis and correlate the degree of diastolic dysfunction to the severity of liver impairment. Methods Thirty-five patients with non-alcoholic liver cirrhosis in addition to 16 age- and sex-matched healthy controls were studied. Severity of liver impairment was assessed using the Child-Pugh score. All participants were subjected to echocardiographic assessment using both the conventional and tissue Doppler echocardiography. The left ventricular filling pressure was derived from the transmitral and mitral annular velocities. Results Patients with non-alcoholic liver cirrhosis (mean age; 53 ± 6) had significantly higher heart rate compared with the controls (86 ± 6.5 vs 72 ± 4 bpm, p = 0.04). Mild degree of left ventricular diastolic dysfunction was detected in 26% of patients using the transmitral diastolic parameters. Compared with controls, the calculated left ventricular filling pressure was statistically significantly higher in patients with non-alcoholic liver cirrhosis (10 ± 3 vs 9 ± 1, p = 0.002). Elevated left ventricular filling pressure was detected in only 4 patients. These patients had more advanced form of liver impairment, and were categorized as having normal left ventricular diastolic function based on the mitral inflow indexes. Conclusions One fourth of patients with non-alcoholic liver cirrhosis had mild degree of left ventricular diastolic dysfunction using the conventional echocardiographic parameters. Elevated resting left ventricular filling pressure was detected in 11% of patients. The use of multiple parameters to assess the left ventricular diastolic function in patients with liver cirrhosis could unmask cases with pseudonormal pattern.