Related Experiment Video
Updated: Aug 15, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Evaluation of subclinical left ventricular systolic dysfunction using two-dimensional speckle-tracking
M Swathi Poojary1, Jyothi Samanth1, Krishnananda Nayak1
1Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576 104, India.
Insights
Cirrhosis patients (Child-Pugh A/B) show normal cardiac mechanics like longitudinal strain and torsion, but subtle diastolic dysfunction. Higher Model for End-Stage Liver Disease (MELD) scores may indicate a hyperdynamic state.
Area of Science:
- Cardiology
- Hepatology
- Medical Imaging
Background:
- Liver cirrhosis impacts cardiac hemodynamics, often presenting with functional alterations in end-stage disease.
- Limited data exists on the relationship between cirrhosis progression, cardiac mechanics, and sub-clinical dysfunction.
- This study investigates ventricular myocardial mechanics in early-stage cirrhosis (Child-Pugh A/B).
Purpose of the Study:
- To assess ventricular myocardial mechanics in patients with Child-Pugh A and B cirrhosis.
- To evaluate cardiac function using speckle tracking and deformation imaging.
- To identify sub-clinical cardiac dysfunction in early-stage liver cirrhosis.
Main Methods:
- Prospective evaluation of 70 cirrhosis patients (Child-Pugh A/B) and 62 healthy controls.
- Standard conventional echocardiography and deformation imaging with rotational echocardiography were performed.
- Clinical staging utilized Model for End-Stage Liver Disease (MELD) scores and Child-Turcotte-Pugh (CTP) classification.
Main Results:
- Cirrhosis patients exhibited significantly higher left ventricular (LV) dimensions and volumes compared to controls.
- Mean ejection fraction (EF) was higher in controls, while left atrial volume was greater in the cirrhosis group, indicating diastolic dysfunction.
- Global longitudinal strain and torsion parameters showed no statistically significant difference between groups.
Conclusions:
- Patients with Child-Pugh A and B cirrhosis have preserved longitudinal strain and normal torsion.
- Subtle diastolic dysfunction is present in these patients.
- Higher MELD scores may correlate with increased longitudinal strain, potentially due to a hyperdynamic state.
Background:
Although studies have proven that liver cirrhosis affects cardiac hemodynamics by means of circulatory overload, they present with definite cardiac functional alteration mostly with end-stage disease. There is limited data on relationship between progression of cirrhosis, cardiac mechanics and sub-clinical dysfunction. This study was done to assess ventricular myocardial mechanics using speckle tracking and deformation imaging among Child-Turcotte-Pugh (CTP) classification A and B cirrhosis.
Method:
Seventy patients with cirrhosis of Child-Pugh A/B class and sixty-two healthy subjects were prospectively evaluated by standard conventional echocardiography and deformation imaging with rotational echocardiography. Clinical stage of liver cirrhosis was assessed by model for end-stage liver disease (MELD) scores and CTP classification.
Results:
Mean ages of patients with cirrhosis and controls were 55.64±14 years and 52.24±12 years, respectively. Though left ventricular (LV) dimensions (end diastolic dimension: 47.27±4.6 mm vs. 45.03±3.8 mm, p = 0.003; end systolic dimension: 30.33±4.9 mm vs. 28.40±2.91 mm, p = 0.006) and volumes (end diastolic volume: 82.08±22.53 mL vs. 68.18±15.75 mL, p = 0.001; end systolic volume: 28.60±8.42 mL vs. 22.18±7.48 mL, p = 0.001) were significantly higher in patients with cirrhosis, mean ejection fraction (EF) by Simpsons method was higher among controls (65.83±5.79% vs. 68.35±5.79%, p = 0.009). Left atrial volume was higher in cirrhosis group indicating presence of diastolic dysfunction (41.24±14.10 mL vs. 26.08±6.4 mL, p = 0.001). Global longitudinal strain as assessed by speckle tracking echocardiography did not show statistical significant difference between two groups (-22.35±4.08% vs. -21.80±2.54%, p = 0.348). Median value of torsion parameters in patients with cirrhosis did not differ compared to controls (torsion in degrees: 2.46 vs. 2.79, p = 0.268).
Conclusion:
Patients with Child-Pugh A and B stages of cirrhosis present with preserved longitudinal strain, normal torsion but with subtle diastolic dysfunction. Higher MELD score may correlate with increased longitudinal strain possibly due to hyperdynamic state.
More Related Videos
09:05Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
07:13Author Spotlight: Advancing Neonatal Cardiac Diagnostics with Echocardiography-Derived Blood Speckle Imaging
Published on: December 22, 2023
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests