Abstract
Background and aimCardiac dysfunction is a prevalent finding in patients with liver cirrhosis. We aimed to evaluate left ventricular function by tissue Doppler imaging in patients with liver cirrhosis.Patients and methodsThis is a cross-sectional case–control study that involved 90 patients with liver cirrhosis: 30 patients with Child A, 30 patients with Child B, and 30 patients with Child C cirrhosis. Moreover, 45 healthy volunteers were included in the study as a control group. All patients and controls were examined by conventional Doppler and tissue Doppler echocardiography.ResultsPatients with liver cirrhosis showed significantly lower ejection fraction (EF) levels than control group (P=0.001), but only nine patients showed EF levels less than 55. Moreover, there is significantly decrease in EF in patients with decompensated cirrhosis than those with compensated cirrhosis (P=0.005). A total of 60 patients showed diastolic dysfunction: 10 patients with Child A, 20 patients with Child B, and 30 patients with Child C cirrhosis. There were significantly differences between patients with liver cirrhosis and control group in the other parameters of systolic (S wave and myocardia performance index) and diastolic (early and late velocity and deceleration and isovolumetric relaxation time) functions.ConclusionPatients with liver cirrhosis showed significantly decreased left ventricular systolic and diastolic functions than control group, which is more pronounced in decompensated than compensated patients.
Highlights
Cardiomyopathy in patients with cirrhosis is defined as ‘chronic cardiac dysfunction in patients with cirrhosis characterized by impaired contractile responsiveness to stress and/or altered diastolic relaxation with electrophysiological abnormalities in the absence of other known cardiac disease’ [1,2,3]
Nine patients in our study showed ejection fraction (EF) levels less than 55, and 40 patients were diagnosed with diastolic dysfunction depending on E/A ration below 1, deceleration time (DT) higher than 200 ms, and isovolumetric relaxation time (IVRT) more than 100 ms [2]
The assessment of left ventricular diastolic function was done using the Doppler beam aligned to the direction of flow, and a 1–2 mm sample volume placed between the tips of the mitral leaflets during diastole, in the apical four-chamber view, for detecting the following: (1) Transmitral early velocity wave (E wave)
Summary
Cardiomyopathy in patients with cirrhosis is defined as ‘chronic cardiac dysfunction in patients with cirrhosis characterized by impaired contractile responsiveness to stress and/or altered diastolic relaxation with electrophysiological abnormalities in the absence of other known cardiac disease’ [1,2,3]. Diagnosis of cardiac dysfunction in patients with cirrhosis mostly depends on noninvasive modalities. Tissue Doppler imaging (TDI) echocardiography is a new modality that detects early deformity and alteration of the myocardial fibers in patients with cirrhosis even in the absence of volume overload and before affecting the function of the heart [10]. Cardiac dysfunction is a prevalent finding in patients with liver cirrhosis. We aimed to evaluate left ventricular function by tissue Doppler imaging in patients with liver cirrhosis. Patients and methods This is a cross-sectional case–control study that involved 90 patients with liver cirrhosis: 30 patients with Child A, 30 patients with Child B, and 30 patients with Child C cirrhosis. All patients and controls were examined by conventional Doppler and tissue Doppler echocardiography
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