Cardiac diastolic dysfunction predicts poor prognosis in patients with decompensated liver cirrhosis

Clinical and Molecular Hepatology
Soon Kyu LeeHyo Jun Ahn

Abstract

Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cardiac dysfunction in patients with liver cirrhosis (LC). However, the effect of LVDD on survival has not been clarified, especially in decompensated LC. We prospectively enrolled 70 patients with decompensated LC, including ascites or variceal bleeding, at Daejeon St. Mary's Hospital from April 2013 to April 2015. The cardiac function of these patients was evaluated using 2D echocardiography with tissue Doppler imaging. The diagnosis of LVDD was based on the American Society of Echocardiography guidelines. The primary endpoint was overall survival. Forty-four patients (62.9%) had LVDD. During follow-up (22.3 months), 18 patients died (16 with LVDD and 2 without LVDD). The survival rate was significantly lower in patients with LVDD than in those without LVDD (31.1 months vs. 42.6 months, P=0.01). In a multivariate analysis, the Child-Pugh score and LVDD were independent predictors of survival. Moreover, patients with a ratio of early filling velocity to early diastolic mitral annular velocity (E/e') ≥ 10 (LVDD grade 2) had lower survival than patients with E/e' ratio < 10. The presence of LVDD is associated with poor survival in patients with decompensa...Continue Reading

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Dec 12, 2018·Clinical and Molecular Hepatology·Yun Bin Lee, Jeong-Hoon Lee
Feb 26, 2019·Expert Review of Gastroenterology & Hepatology·Søren MøllerFlemming Bendtsen
Apr 17, 2020·Echocardiography·Prabhakaran Gopalakrishnan, Robert Biederman
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Dec 21, 2020·Liver International : Official Journal of the International Association for the Study of the Liver·Marcel RazpotnikMarkus Peck-Radosavljevic
Apr 12, 2021·Clinics in Liver Disease·Manhal J Izzy, Lisa B VanWagner

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