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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
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A case-cohort study of left ventricular diastolic dysfunction in patients with cirrhosis: the liver-heart axis

Rushil Solanki1, Srijaya Sreesh1, Thomas Varghese Attumalil2

  • 1Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas).

Annals of Gastroenterology
|November 29, 2023
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) in cirrhosis patients is linked to disease severity and complications. Ascitic fluid protein levels may predict LVDD, indicating poorer survival outcomes.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Left ventricular diastolic dysfunction (LVDD) is an early indicator of cirrhotic cardiomyopathy.
  • The clinical significance of LVDD in cirrhosis patients requires further investigation.
  • This study examines the association between LVDD and cirrhosis severity, complications, and survival.

Purpose of the Study:

  • To assess the clinical significance of LVDD in patients with cirrhosis.
  • To identify factors associated with LVDD in cirrhosis.
  • To evaluate the impact of LVDD on survival in cirrhosis patients.

Main Methods:

  • 203 cirrhosis patients underwent 2D echocardiography with tissue Doppler imaging.
  • 139 patients with LVDD were compared to 64 controls without LVDD.
  • Logistic regression and Kaplan-Meier analyses were employed.

Main Results:

  • LVDD was significantly associated with higher Child-Turcotte-Pugh (CTP) class C, MELD scores, ascites, hepatic encephalopathy, and hepatorenal syndrome.
  • Nonalcoholic steatohepatitis (NASH)-related cirrhosis showed a stronger association with LVDD.
  • Multivariate analysis identified higher CTP score, ascitic fluid protein, and prolonged QTc interval as independent predictors of LVDD.

Conclusions:

  • Higher CTP score, prolonged QTc, and elevated ascitic fluid protein are significantly associated with LVDD in cirrhosis.
  • Ascitic fluid protein >1 g/dL may serve as a predictor for evaluating LVDD.
  • LVDD is linked to poorer survival outcomes in cirrhosis patients.
Abstract

Keywords:
Left ventricular diastolic dysfunctioncardiomyopathycirrhosispredictorssurvival

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