Left Ventricular Diastolic Dysfunction Increases the Risk of Medium-term Mortality in Patients with Cirrhotic Ascites

To elucidate the impact of left ventricular diastolic dysfunction (LVDD) on the risk of medium-term poor prognosis in patients with cirrhotic ascites.

A total of 194 patients with cirrhotic ascites were included in this retrospective study and categorized into two groups (LVDD and non-LVDD) based on echocardiography findings. Lasso and univariate Cox regression analyses were initially used to screen potential influencing factors of 1-year mortality from basic clinical data. Multivariate Cox regression was then performed to identify independent risk factors. Kaplan-Meier (K-M) and time-dependent receiver operating characteristic (ROC) curves were used to assess the predictive value of LVDD for 1-year mortality. Subgroup analysis was also conducted based on the presence or absence of hepatic malignancy.

(1)LVDD was present in 47.4% (92/194) of patients with cirrhotic ascites; (2)Regression analyses (Lasso, univariate Cox, and multivariate Cox) revealed that LVDD (hazard ratio = 2.109, 95% confidence interval [1.279-3.478], P = 0.003) was an independent risk factor for 1-year mortality; (3)Time-dependent ROC curves demonstrated that the predictive performance of LVDD for 360-day mortality, in the overall population and patients without hepatic malignancy, was comparable to that of traditional Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores (P > 0.05 for all).

LVDD increases the risk of 1-year mortality in patients with cirrhotic ascites, particularly in those without hepatic malignancy.