Right heart impairement in cirrhotic patients

Abstract

Right ventricular dysfunction in cirrhotic patients is not well described, we suggest that cirrhosis will result in an increase of pulmonary resistance and the post-charge of RV, we aim to assess ventricle function in cirrhotic patients and the correlation between the severity of cirrhosis and the RV dysfunction. We assessed echocardiographic RV systolic function in 80 patients with cirrhosis. We compared compensated ( n = 39) and uncompensated patients ( n = 41) to controls ( n = 80). The severity of cirrhotic disease was assessed by Child and Mild scores. RV was significantly enlarged in cirrhotic patients compared to controls and in uncompensated patients compared to compensated patients (RV diastolic area = 16.7 ± 5 cm 2 , 14.5 ± 4 cm 2 , P = 0.01). The TAPSE and the S wave were significantly lower in cirrhotic patients ( P = 0.007) compared to controls but there were no difference between the sub-groups. Longitudinal peak systolic speckle tracking of lateral RV wall was significantly decreased in cirrhotic patients ( P < 0.001). There was no correlation between the different parameters of the RV and Child as well as Mild scores. The present study illustrated RV systolic function impairment in cirrhotic patients. The lack of correlation between the right ventricle dysfunction and the severity of cirrhosis suggest a complex mechanism. Right ventricular dysfunction in cirrhotic patients is not well described, we suggest that cirrhosis will result in an increase of pulmonary resistance and the post-charge of RV, we aim to assess ventricle function in cirrhotic patients and the correlation between the severity of cirrhosis and the RV dysfunction. We assessed echocardiographic RV systolic function in 80 patients with cirrhosis. We compared compensated ( n = 39) and uncompensated patients ( n = 41) to controls ( n = 80). The severity of cirrhotic disease was assessed by Child and Mild scores. RV was significantly enlarged in cirrhotic patients compared to controls and in uncompensated patients compared to compensated patients (RV diastolic area = 16.7 ± 5 cm 2 , 14.5 ± 4 cm 2 , P = 0.01). The TAPSE and the S wave were significantly lower in cirrhotic patients ( P = 0.007) compared to controls but there were no difference between the sub-groups. Longitudinal peak systolic speckle tracking of lateral RV wall was significantly decreased in cirrhotic patients ( P < 0.001). There was no correlation between the different parameters of the RV and Child as well as Mild scores. The present study illustrated RV systolic function impairment in cirrhotic patients. The lack of correlation between the right ventricle dysfunction and the severity of cirrhosis suggest a complex mechanism.