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Systolic dysfunction and diastolic dysfunction do not influence medium-term prognosis in patients with cirrhosis

Francisco Sampaio1, Joana Pimenta2, Nuno Bettencourt1

  • 1Cardiology Department, Centro Hospitalar de Gaia/Espinho, R. Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal; University of Porto Medical School, Al. Prof. Hernani Monteiro, 4200-319 Porto, Portugal.

European Journal of Internal Medicine
|February 4, 2014
PubMed

Insights

Liver disease severity, not cardiac dysfunction, predicts mortality in cirrhosis patients over six months. Advanced echocardiography did not identify high-risk individuals for death.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Myocardial dysfunction is observed in cirrhosis patients, potentially affecting hemodynamics in advanced stages.
  • The prognostic significance of cardiac systolic and diastolic dysfunction in cirrhosis remains debated.

Purpose of the Study:

  • To assess echocardiographic parameters of cardiac function as medium-term prognostic markers in cirrhotic patients.
  • To determine if cardiac function indices can predict mortality in this population.

Main Methods:

  • Prospective evaluation of 98 cirrhotic patients (52 hospitalized, 46 ambulatory).
  • Comprehensive echocardiography, including tissue-Doppler and speckle tracking, performed at baseline.
  • Follow-up for 6 months to record mortality events.

Main Results:

  • Twenty deaths occurred within the 6-month follow-up period.
  • No echocardiographic parameters independently predicted mortality.
  • Child score >10 and mean arterial pressure below median were independent predictors of mortality.
  • Associations of cardiac output, C-reactive protein, and albumin with mortality were lost after adjusting for Child score.

Conclusions:

  • Liver disease severity, indicated by Child score, is the primary determinant of medium-term mortality in cirrhosis.
  • Current echocardiographic indices of systolic and diastolic function are not effective in identifying cirrhotic patients at high risk of death.
Abstract

Keywords:
Cardiac functionCirrhosisEchocardiographyPrognosis

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