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Updated: Nov 5, 2025

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Diagnosis and Prevalence of Cirrhotic Cardiomyopathy: A Systematic Review and Meta-analysis

Seyed Alireza Shahvaran1, Orsolya Menyhárt2, Lisa Csedrik3

  • 1Interdisciplinary Gastroenterology Working Group, Semmelweis University, Budapest, Hungary.

Current Problems in Cardiology
|May 21, 2021
PubMed

Insights

Cirrhotic cardiomyopathy (CCM) is prevalent in 61% of patients using standard echocardiograms, but only 45% when using tissue Doppler imaging (TDI). TDI offers a more accurate diagnosis of cardiac dysfunction in cirrhosis.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Medical Diagnostics

Background:

  • Cirrhotic cardiomyopathy (CCM) is a complex cardiac dysfunction affecting patients with liver cirrhosis.
  • Current diagnostic criteria rely on echocardiography, but the sensitivity and specificity vary.
  • Tissue Doppler imaging (TDI) shows promise for more accurate cardiac assessment in cirrhosis.

Purpose of the Study:

  • To estimate the pooled prevalence of CCM using conventional 2D echocardiography and TDI.
  • To compare the diagnostic accuracy of 2D echocardiography versus TDI for CCM.
  • To establish population-specific echocardiographic values for cirrhotic patients.

Main Methods:

  • Meta-analysis of 12 selected cohort studies.
  • Inclusion of studies using either conventional 2D echocardiography or TDI for CCM diagnosis.
  • Analysis of echocardiographic data from 615 cirrhotic patients.

Main Results:

  • The pooled prevalence of CCM was 61% using the 2005 criteria with conventional echocardiography.
  • Using TDI, the pooled prevalence of CCM decreased to 45%.
  • Mean echocardiographic values in cirrhotic patients included LVEF 63.52%, deceleration time 229.04 ms, IVRT 87.71 ms, and E/A ratio 1.04.

Conclusions:

  • Conventional 2D echocardiography may lead to overdiagnosis of CCM compared to TDI.
  • TDI demonstrates higher sensitivity and specificity for detecting cardiac dysfunction in cirrhotic patients.
  • Accurate diagnosis of CCM is crucial for patient management and prognosis.

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