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Updated: Jun 25, 2025
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
The right ventricle outflow tract systolic function could predict the severity of the cirrhosis
İbrahim Dönmez1, Güray Can2, Emrah Acar1
1Department of Cardiology, Faculty of Medicine, Bolu Abant İzzet Baysal University, Bolu, Turkiye.
Insights
Right ventricular outflow tract-systolic excursion (RVOT-SE) is linked to cirrhosis severity. This study found RVOT-SE can predict decompensated cirrhosis, suggesting its potential as a diagnostic marker.
Area of Science:
- Cardiology
- Hepatology
- Medical Imaging
Background:
- Cirrhosis, characterized by liver fibrosis and nodule formation, is associated with cardiac dysfunction, termed cirrhotic cardiomyopathy (CCM).
- Right ventricular outflow tract (RVOT) function is crucial for overall right ventricular performance.
- Right ventricular outflow tract-systolic excursion (RVOT-SE) is a key marker for RVOT systolic function, yet its role in cirrhosis remains unexplored.
Purpose of the Study:
- To investigate the relationship between the severity of cirrhosis and RVOT-SE.
- To assess the potential of RVOT-SE as a predictor of decompensated cirrhosis.
Main Methods:
- Sixty-nine cirrhotic patients were evaluated using medical history, physical examination, lab tests, and echocardiography.
- Patients were classified into compensated (Child-Pugh class 1) and decompensated (Child-Pugh class 2-3) cirrhosis groups.
- Echocardiographic parameters, including RVOT-SE, were analyzed and compared between groups.
Main Results:
- No significant differences in left ventricular parameters were observed between groups.
- Statistically significant differences were found in Right Ventricle Wall (RVW), systolic pulmonary artery pressure (sPAP), RVOT-SE, and Tricuspid Annular Plane Systolic Excursion (TAPSE) across cirrhosis severity groups (p < 0.05).
- RVOT-SE positively correlated with cirrhosis severity (OR: 0.607, p = 0.006) and ROC analysis indicated RVOT-SE 8.8 cm/s predicted decompensated cirrhosis with 72% sensitivity and 72.7% specificity (AUC = 0.715, p = 0.001).
Conclusions:
- RVOT-SE is significantly associated with the severity of cirrhosis.
- RVOT-SE demonstrates potential as a non-invasive marker for predicting decompensated cirrhosis.
- Further multi-center studies with larger cohorts are warranted to validate these findings.
Background/Aim:
The distinctive liver framework is converted into structurally abnormal nodules as a consequence of tissue fibrosis in cirrhosis. Cardiac dysfunction in cirrhosis was described, and the term "cirrhotic cardiomyopathy (CCM)" was coined to describe this syndrome. Recent research has shown that the contractile characteristics of the right ventricular outflow tract (RVOT) have a significant impact on right ventricular functions. The right ventricular outflow tract-systolic excursion is an important systolic function marker of RVOT (RVOT-SE). There has yet to be published research on RVOT function in cirrhotic patients. We looked at the relationship between cirrhosis severity and the RVOT-SE.
Materials And Methods:
Sixty-nine consecutive hepatic cirrhotic patients were recruited for the research between June 1, 2018 and January 1, 2022. A medical history, thorough physical examination, laboratory investigations, echocardiographic evaluation, and RVOT-SE were obtained. The patients were separated into two groups: those with compensated cirrhosis (Child-Pugh class 1) and those with decompensated cirrhosis (Child-Pugh class 2 and 3).
Results:
On the numerous standard echocardiographic parameters that examined the diameter and function of the left ventricle, we observed no significant difference between groups. Nevertheless, a statistically significant difference in Right Ventricle Wall (RVW) (p = 0.014), systolic pulmonary artery pressure (sPAP) (p = 0.034), RVOT-SE (p = 0.003), and Tricuspid Annular Plane Systolic Excursion (TAPSE) (p = 0.042) was detected across cirrhosis groups. The RVOT-SE had a positive correlation with cirrhosis severity (OR: 0.607; 95% CI: 0.425-0.866; p = 0.006), according to multiple logistic regression studies. According to the ROC curve study, RVOT-SE 8.8 cm/s predicted decompensated cirrhosis with 72% sensitivity and 72.7% specificity (AUC = 0.715, p: 0.001).
Conclusion:
In the current study, we found that RVOT-SE was related to the severity of cirrhosis. Larger patient cohorts and multi-center investigations will provide light on the notion.
