Assessment of systolic function in the evaluation of patients with cirrhosis

Clinical Consequences of Cardiomyopathy in Children With Biliary Atresia Requiring Liver Transplantation

“…In adults, systolic dysfunction in cirrhosis is defined as decreased ejection fraction and blunted cardiac output in response to stressors, which has not reliably been demonstrated in children . In contrast, an elevated SF, which is more in line with the hyperdynamic state found in adults with cirrhosis at rest, was demonstrated in children …”

“…(14,15) In contrast, an elevated SF, which is more in line with the hyperdynamic state found in adults with cirrhosis at rest, was demonstrated in children. (2,4,11,15,38) Our primary aim was to derive a set of consistent, easily obtainable, and pediatric specific 2DE parameters that better identified adverse events associated with ESLD secondary to BA. This analysis first resulted in the exclusion of SF from criteria because of its complete lack of significance with any clinically relevant outcomes.…”

The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis

“…We have therefore recently put forward the hypothesis of the presence of a cardiorenal syndrome in cirrhosis, which indicates that cardiac dysfunction in cirrhosis is a major determinant of the course of patients who develop HRS . In patients with cirrhosis, the term “cardiorenal” suggests a condition in which progressive renal dysfunction is related to a decline in cardiac systolic function . Therefore, considering the renal changes in end‐stage liver disease as a cardiorenal syndrome comparable to what is observed in, for example, patients with advanced cardiac failure may increase our understanding on the pathophysiologic course in chronic liver disease.…”

Pressure volume curves in cirrhosis: More than meets the eye

“…3,4 Indeed, in previous work which included patients with cirrhosis specifically designed to clinically validate ultrasound-based methods of global systolic function, we demonstrated that the single-beat approach for estimating Ees, using the method applied by Shin et al, had a poor correlation with the reference invasive Ees (R = 0.25). 5 The difficulty of obtaining load independent measurements of systolic function using conventional Doppler echocardiography 6,7 makes us question whether the parameters measured by Shin et al are really associated with intrinsic cardiac performance or just reflect the complex hemodynamic profile of patients with end-stage liver disease. In a recently published study, 8 we have evaluated systolic function in patients with cirrhosis using a non-invasive index, the ejection intraventricular pressure difference (EIVPD), that had been previously validated against the gold standard method in the aforementioned study.…”