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Cardiac dysfunction as an early predictor of portal hypertension in chronic hepatitis C

Cecilia Marconi1, Mattia Bellan2,3, Paola Giarda1,3

  • 1Division of Internal Medicine "AOU Maggiore della Carità", Novara (Cecilia Marconi, Paola Giarda, Rosalba Minisini, Serena Favretto, Michela Emma Burlone, Liza Franzosi, Mario Parisi), Italy.

Annals of Gastroenterology
|November 10, 2017
PubMed

Insights

Cirrhotic cardiomyopathy involves heart changes in advanced liver disease. Echocardiography reveals left atrial enlargement and altered systolic velocities, correlating with portal hypertension complications.

Area of Science:

  • Cardiology
  • Hepatology
  • Medical Imaging

Background:

  • Cirrhotic cardiomyopathy is a cardiovascular complication of advanced chronic liver disease.
  • Characterized by specific cardiac modifications, it impacts patient prognosis.
  • Understanding these alterations is crucial for managing liver disease progression.

Purpose of the Study:

  • To investigate cardiovascular alterations in chronic liver disease across different fibrosis stages.
  • To correlate cardiac changes with endoscopic findings of portal hypertension.
  • To identify potential echocardiographic markers for risk stratification.

Main Methods:

  • Seventy patients with chronic hepatitis C-related liver disease and 20 controls underwent clinical evaluation, transient elastography, and echocardiography.
  • Liver stiffness (LS) measured fibrosis severity.
  • Esophagogastroduodenoscopy screened for esophageal and gastric varices in 49 patients.

Main Results:

  • Cirrhotic patients (LS > 12.5 kPa) exhibited significant left atrial dilatation compared to non-cirrhotics (LS < 12.5 kPa).
  • Tissue Doppler imaging revealed lower peak systolic wave velocity (S¢) in cirrhotics, indicating diastolic dysfunction, but ejection fraction remained preserved.
  • Left atrial volume, left ventricular mass index, and TDI S¢ velocity correlated with endoscopic signs of portal hypertension.

Conclusions:

  • Left atrial enlargement and reduced peak S¢ systolic velocities are echocardiographic indicators of cardiac dysfunction in liver cirrhosis.
  • These cardiac alterations show a close correlation with endoscopic findings of portal hypertension.
  • Echocardiography may aid in identifying cirrhotic patients at higher risk for portal hypertension complications.
Abstract

Keywords:
Cirrhotic cardiomyopathyechocardiographyhepatitis Cportal hypertension

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