Modification of cardiac function in cirrhotic patients with and without ascites

Valeriano, Valentina; Funaro, Stefania; Lionetti, Raffaella; Riggio, Oliviero; Pulcinelli, Giovanna; Fiore, Piera Filomena; Masini, Andrea; Castro, S. De; Merli, Manuela

doi:10.1111/j.1572-0241.2000.03252.x

Cited by 121 publications

(50 citation statements)

References 30 publications

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“…Our findings in this selected population further corroborate previous findings by other authors [13][14][15] and by our group [12], indicating that diastolic dysfunction is an expression of cardiac involvement paralleling progression of cirrhosis. Indeed our data, based on the historical comparison with the Framingham study [43] suggest that age, one of the components involved in the pathogenesis of diastolic dysfunction and possibly a misleading issue in previous investigations, can be excluded at least as a co-factor.…”

Section: Discussionsupporting

confidence: 82%

“…This alteration is more marked in presence of ascites, presumably because the increased intrathoracic pressure and the bulging of the diaphragm, induced by abdominal fluid accumulation, interfere with the diastolic expansion of the ventricles [15]. It is present, however, even in absence of ascites, suggesting that non-mechanical factors are involved as well [12,3].…”

Section: Discussionmentioning

confidence: 86%

“…Hyperdinamic circulation [3], QTc prolongation [4,5], beta-receptors desensitization [6,7], reduced systolic competence under strains [8][9][10][11] and diastolic dysfunction [12][13][14][15][16][17] are the key features of cirrhotic cardiomyopathy. Diastolic dysfunction, characterized by an altered pattern of transmitral flow due to impaired diastolic relaxation of left ventricle, can be easily assessed by echocardiography and accordingly can be considered as a marker of this condition.…”

Section: Introductionmentioning

confidence: 99%

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Heart Function and Myocardial Tissue Characterization in Patients with HCV Related Cirrhosis: Diastolic Dysfunction and Cardiac Hypertrophy

Pozzi¹,

Pizzala²,

Ratti³

et al. 2007

TOGASJ

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Evidence of diastolic dysfunction in cirrhosis contributed to the definition of cirrhotic cardiomyopathy. In 109 patients with chronic HCV infection with or without cirrhosis E/A ratio, a Doppler marker of diastolic dysfunction, was decreased in cirrhotics (0.89 ± 0.03 vs controls 1.21 ± 0.07, p < 0.01) and to a lesser extent in patients with advanced liver fibrosis (1.17 ± 0.07, p < 0.01). Left ventricular parietal wall thickness was increased. The nature of this abnormality in human cirrhosis has not been clarified, animal studies reporting cardiac hypertrophy. To this aim we employed the echocardiographic integrated backscatter (IBS) technique to obtain an indirect estimate of tissue density (decreased when a higher percentage of muscle fibres is present and increased when fibrosis prevails) to provide myocardial tissue characterization in a subset of patients with compensated HCV cirrhosis. The average IBS signal was reduced in cirrhotics at the level of the posterior wall (21.72 ± 1.46 dB versus 30.85 ± 1.40 dB in controls, p < 0.01). Our results confirm diastolic dysfunction in postviral cirrhosis pointing to cardiac hypertrophy as the anatomopathological background in the compensated stage of disease.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Heart Function and Myocardial Tissue Characterization in Patients with HCV Related Cirrhosis: Diastolic Dysfunction and Cardiac Hypertrophy

Pozzi¹,

Pizzala²,

Ratti³

et al. 2007

TOGASJ

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“…There are conflicting data about the correlation between the presence of ascites in patients with liver cirrhosis and the prevalence of LV diastolic dysfunction [12,20,23]. In an earlier study, LV diastolic dysfunction in cirrhotics showed a significant improvement after total paracentesis in patients with tense ascites suggesting that LV diastolic dysfunction in these patients might be in part secondary to physical factors such as higher hemodynamic overload, increased intrathoracic pressure, and elevation of the diaphragm by abdominal fluid accumulation [24].…”

Section: Diastolic Dysfunction In Patients With Liver Cirrhosismentioning

confidence: 99%

Untitled

2016

BAOJMN

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AimTo assess noninvasively the left ventricular filling pressure in patients with liver cirrhosis. MethodsThirty-five patients with liver cirrhosis were enrolled in the study in addition to 16 age-and sex-matched controls. All participants were subjected to full echocardiographic assessment. Evaluation of the left ventricular diastolic function and filling pressure was made using both the conventional and tissue Doppler imaging. ResultsHeart rate was significantly higher in patients with liver cirrhosis compared with the controls (86 ± 6.5 bpm vs 72± 4, P = 0.04).The mitral E/A ratio was significantly lower in patients with liver cirrhosis (mean age, 53±6 years) and was correlated with the severity of liver impairment (P = 0.04, r = -0.335). Compared to the controls, the left ventricular filling pressure was significantly elevated in patients with liver cirrhosis (10±3 vs 9±1, P = 0.002). All patients with elevated filling pressure (75% of them were females) had more advanced form of liver impairment, and were categorized as having normal left ventricular diastolic functions using the mitral inflow indexes. ConclusionsThe resting left ventricular filling pressure is elevated in patients with liver cirrhosis. Further studies are warranted to determine whether these patients are more prone to the development of cardiac complications (mainly pulmonary edema) following liver transplantation. The use of multiple parameters, rather than the mitral indexes only, to assess the left ventricular diastolic functions in patients with liver cirrhosis is recommended.

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“…[7,8,9,10] The prevalence and extent of systolic dysfunction in cirrhotic patients appear to be variable.…”

mentioning

confidence: 99%

A Study of Changes in Cardiac Echocardiography in Cirrhosis of Liver

Boddu¹,

C²

2016

jemds

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BACKGROUNDCirrhosis of liver with portal hypertension results in hyperdynamic circulatory state. This is associated with a variety of cardiovascular alterations. In addition, the heart in patients with cirrhosis presents with structural and functional abnormalities that have been termed cirrhotic cardiomyopathy.The aim of this study is to assess the changes in cardiac echocardiography in patients with cirrhosis of liver.

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Modification of cardiac function in cirrhotic patients with and without ascites

Abstract: Liver cirrhosis is associated with enlarged right cardiac chambers. Diastolic dysfunction and mild pulmonary hypertension are evident in cirrhotic patients with ascites. These changes do not depend on variations in the left ventricular geometry.

Cited by 121 publications

References 30 publications

Heart Function and Myocardial Tissue Characterization in Patients with HCV Related Cirrhosis: Diastolic Dysfunction and Cardiac Hypertrophy

Heart Function and Myocardial Tissue Characterization in Patients with HCV Related Cirrhosis: Diastolic Dysfunction and Cardiac Hypertrophy

Untitled

A Study of Changes in Cardiac Echocardiography in Cirrhosis of Liver

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