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Updated: Jan 29, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

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Diastolic dysfunction on echocardiography does not predict survival after transjugular intrahepatic portosystemic

Matthew J Armstrong1,2, Farhan Gohar1, Amritpal Dhaliwal1,2

  • 1Liver Unit, Queen Elizabeth University Hospital, Birmingham, UK.

Alimentary Pharmacology & Therapeutics
|February 19, 2019
PubMed

Insights

Echocardiography parameters do not predict survival after transjugular intrahepatic portosystemic stent-shunt (TIPS) in cirrhosis patients. Model for End-Stage Liver Disease and Child-Pugh scores are the best survival predictors. Further study is needed.

Area of Science:

  • Cardiology
  • Hepatology
  • Medical Imaging

Background:

  • Cardiac dysfunction is common in cirrhosis patients.
  • Limited data exists on echocardiography's role in pre-TIPS assessment.
  • This study investigates echocardiography's predictive value for TIPS outcomes.

Purpose of the Study:

  • To determine if echocardiography parameters predict survival post-TIPS in cirrhosis.
  • To assess the utility of routine echocardiography before TIPS procedures.

Main Methods:

  • Retrospective review of 117 cirrhosis patients undergoing TIPS (1999-2016).
  • Independent cardiologist review of echocardiography measures, including LVEF and diastolic dysfunction.
  • Analysis of predictors for 30-day and overall transplant-free survival.

Main Results:

  • Model for End-Stage Liver Disease (MELD) and Child-Pugh scores significantly predicted survival.
  • MELD ≥15 indicated a three-fold increased risk of death.
  • No echocardiography parameters pre-TIPS correlated with survival outcomes.
  • 33% of patients had diastolic dysfunction; 50% had abnormal echocardiograms.

Conclusions:

  • Diastolic dysfunction does not predict survival after TIPS in cirrhosis.
  • MELD and Child-Pugh scores remain the primary survival predictors.
  • Prospective studies are needed to clarify the role of routine echocardiography prior to TIPS.
Abstract

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