Cor Vasa 2017, 59(6):e540-e545 | DOI: 10.1016/j.crvasa.2016.12.011

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

Heba Farouk^a,*, Taha Al-Maimoony^a, Abdo Nasr^a, Magdy El-Serafy^b, Mohamed Abdel Ghany^a

^a Cardiovascular Medicine Department, Faculty of Medicine, Cairo University, Egypt

^b Department of Tropical Medicine, Faculty of Medicine, Cairo University, Egypt

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 bpm vs 72 ± 4, 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.

Keywords: Cardiac complications; Left ventricular diastolic function; Left ventricular filling pressure; Liver cirrhosis; Liver transplantation; Mitral indexes

Received: June 24, 2016; Accepted: December 20, 2016; Published: December 1, 2017  Show citation