Left ventricular diastolic function in liver cirrhosis

Scand J Gastroenterol. 1996 Mar;31(3):279-84. doi: 10.3109/00365529609004879.

Abstract

Background: Left ventricular systolic abnormalities have been reported in liver cirrhosis (LC). Diastolic function in cirrhotics, on the contrary, does not seem to have been studied so far.

Methods: Diastolic function was evaluated in 42 cirrhotic patients and in 16 controls by means of Doppler echocardiography.

Results: Compared with the controls, cirrhotics had increased left ventricular end-diastolic and left atrial volume, stroke volume, late diastolic flow velocity (peak A) (71 + or - 17 cm/sec versus 56 +/- 18; p <0.01), time from onset of mitral inflow to the early peak (time E) (86 + or - 11 msec versus 72 +/- 14; p < 0.003), and deceleration time (DT) (194 +/- 40 msec versus 159 +/- 27; p < 0.001) and decreased ratio of peak E to peak A filling velocities (1.02 +/ - 0.35 versus 1.22 +/- 0.25; p < 0.02). Patients with tense ascites had a higher E/A ratio (p < 0.03) and a shorter DT (p < 0.03) than patients with mild or no ascites.

Conclusions: The impaired left ventricular relaxation in the presence of high stroke volume suggests a myocardial involvement in LC. The pseudo normalization of the E/A ratio and DT in patients with tense ascites could reflect loading conditions masking the relaxation abnormality.

MeSH terms

  • Ascites / complications
  • Blood Pressure
  • Cardiac Output
  • Diastole
  • Echocardiography, Doppler
  • Female
  • Heart Rate
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / physiopathology*
  • Male
  • Middle Aged
  • Stroke Volume
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Function, Left*