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Diastolic dysfunction in cirrhosis

Søren Møller1, Signe Wiese2, Hanne Halgreen2

  • 1Department of Clinical Physiology and Nuclear Medicine 260, Centre for Functional Imaging and Research, Faculty of Health Sciences, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark. soeren.moeller@regionh.dk.

Heart Failure Reviews
|April 15, 2016
PubMed

Insights

Cirrhotic cardiomyopathy, characterized by diastolic dysfunction (DD), complicates liver cirrhosis, impacting patient prognosis. Early detection and understanding of DD are crucial for managing cirrhotic patients and improving outcomes.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Cirrhosis complications include esophageal varices, ascites, and hepatic nephropathy.
  • Cirrhotic cardiomyopathy, specifically left ventricular diastolic dysfunction (DD), worsens disease progression and prognosis.
  • Increased cardiac stiffness in cirrhosis leads to decreased compliance and diastolic dysfunction.

Purpose of the Study:

  • To investigate the prevalence and implications of diastolic dysfunction (DD) in patients with liver cirrhosis.
  • To explore the relationship between DD and liver dysfunction severity, ascites, and treatment outcomes.
  • To identify pathophysiological mechanisms of DD in cirrhosis.

Main Methods:

  • Prevalence assessment of DD in cirrhotic patients.
  • Evaluation of DD using transmitral Doppler echocardiography, tissue Doppler echocardiography, and cardiac magnetic resonance imaging.
  • Analysis of DD's association with liver dysfunction, ascites, liver transplantation, and transjugular intrahepatic portosystemic shunt (TIPS) insertion.

Main Results:

  • Diastolic dysfunction (DD) affects approximately 50% of cirrhotic patients.
  • DD correlates with the severity of liver dysfunction and the presence of ascites.
  • DD is linked to poorer prognosis post-liver transplantation and after TIPS insertion, although it may improve post-transplant.

Conclusions:

  • Diastolic dysfunction (DD) is a significant complication of cirrhosis with prognostic implications.
  • DD influences outcomes after liver transplantation and TIPS procedures.
  • Further research is needed to elucidate the underlying mechanisms of DD in cirrhosis.

Keywords:
Cardiac dysfunctionCirrhotic cardiomyopathyHyperdynamic syndromeSystolic dysfunctionVasodilatation

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