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Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
09:37

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats

Published on: August 1, 2018

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Cardiac dysfunction in cirrhotic portal hypertension with or without ascites

Sunil Dadhich1, Amitava Goswami1, Vinit Kumar Jain2

  • 1Department of Gastroenterology (Sunil Dadhich, Amitava Goswami, Ganaraj Kulamarva, Narendra Bhargava), Dr Sampurnanand Medical College, Jodhpur.

Annals of Gastroenterology
|July 1, 2014
PubMed

Insights

Liver cirrhosis commonly causes left ventricular diastolic dysfunction, even before ascites develop. Systolic function remains preserved until late stages of liver failure, with tissue Doppler imaging accurately assessing diastolic dysfunction.

Area of Science:

  • Cardiology
  • Hepatology
  • Medical Imaging

Background:

  • Cardiovascular function alterations are noted in liver cirrhosis and correlate with hepatic failure severity.
  • Conventional 2-D echocardiography has limitations in assessing cardiac function in these patients.

Purpose of the Study:

  • To evaluate cardiac systolic and diastolic functions in liver cirrhosis patients with or without ascites.
  • To compare findings between healthy controls, pre-ascitic cirrhosis, and cirrhotic patients with ascites.

Main Methods:

  • A cross-sectional case-control study involving sixty patients (20 per group: healthy controls, pre-ascitic cirrhosis, cirrhotic with ascites).
  • Cardiac evaluation using conventional Doppler and tissue Doppler echocardiography.

Main Results:

  • Cirrhosis with portal hypertension showed increased heart rate, ejection fraction, and mean peak systolic velocity, with decreased mean arterial pressure.
  • Left atrial dilation was common; the E/e' ratio was a significant marker for diastolic dysfunction (7.76±0.40 in controls, 12.55±1.73 in pre-ascitic, 11.4±1.19 in ascitic; P<0.0001).
  • 70% of cirrhotic patients exhibited Type I and II left ventricular diastolic dysfunction, with no cases of Type III.

Conclusions:

  • Left ventricular diastolic dysfunction is prevalent in advanced hepatic dysfunction, while systolic function is maintained.
  • Pulsed tissue Doppler imaging accurately assesses parameters like peak early diastolic wave velocity and E/e' ratio for diagnosing left ventricular diastolic dysfunction.
Abstract

Keywords:
Tissue Doppler imagingearly diastolic velocitylate diastolic velocitypeak early diastolic wave velocitypeak systolic velocity

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