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The prevalence of cirrhotic cardiomyopathy according to different diagnostic criteria

Marcel Razpotnik1, Simona Bota1, Philipp Wimmer2

  • 1Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology, Nephrology and Emergency Medicine (ZAE), Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria.

Liver International : Official Journal of the International Association for the Study of the Liver
|December 20, 2020
PubMed

Insights

Cirrhotic cardiomyopathy affects about 60% of patients. The 2019 Cirrhotic Cardiomyopathy Consortium (CCC) criteria identify more cases of systolic dysfunction in cirrhosis compared to older guidelines.

Area of Science:

  • Cardiology
  • Hepatology
  • Medical Diagnostics

Background:

  • Cirrhotic cardiomyopathy (CC) is a complex condition affecting cardiac function in patients with liver cirrhosis.
  • Recent diagnostic criteria, such as the 2019 Cirrhotic Cardiomyopathy Consortium (CCC) guidelines, have updated thresholds for systolic dysfunction and incorporated advanced imaging techniques.
  • Discrepancies exist between various diagnostic criteria, necessitating an evaluation of their prevalence in cirrhotic populations.

Purpose of the Study:

  • To assess and compare the prevalence of cirrhotic cardiomyopathy using different diagnostic criteria.
  • To evaluate the impact of the 2019 CCC criteria on the diagnosis of systolic and diastolic dysfunction in cirrhotic patients.

Main Methods:

  • The study enrolled 122 cirrhotic patients meeting specific inclusion criteria, excluding those with other cardiac conditions or complications.
  • Speckle-tracking echocardiography was performed by certified investigators.
  • Prevalence of CC was determined using the 2005 Montreal recommendations, 2009 ASE/EACVI guidelines, and 2019 CCC criteria.

Main Results:

  • The overall prevalence of CC was similar between the 2005 Montreal (67.2%) and 2019 CCC (55.7%) criteria.
  • However, CC prevalence was significantly higher with both sets of criteria compared to the 2009 ASE/EACVI guidelines (35.2%).
  • The 2019 CCC criteria identified a significantly higher prevalence of systolic dysfunction (53.3%) compared to the 2005 Montreal (16.4%) and 2009 ASE/EACVI (4.9%) criteria.

Conclusions:

  • Cirrhotic cardiomyopathy is highly prevalent, affecting approximately 60% of patients when assessed by hepatological criteria.
  • The 2019 CCC criteria reveal a substantially higher prevalence of systolic dysfunction in cirrhotic patients.
  • Further longitudinal studies are required to validate the prognostic significance of these updated diagnostic criteria for cirrhotic cardiomyopathy.
Abstract

Keywords:
cirrhosiscirrhotic cardiomyopathydiagnostic criteriaprevalencestrain imaging

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