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A case-cohort study of left ventricular diastolic dysfunction in patients with cirrhosis: the liver–heart axis

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Ελληνική Γαστροεντερολογική Εταιρία   

Αποθετήριο :
Annals of Gastroenterology   

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A case-cohort study of left ventricular diastolic dysfunction in patients with cirrhosis: the liver–heart axis (EN)
Mohapatra, Shivabrata dhal
Solanki, Rushil
Sreesh, Srijaya
Chakravorty, Avisek
Nair, Anjana Nalina Kumari kesavan
Pal, Ravindra
Attumalil, Thomas Varghese
Madhu, Devika
Devadas, Krishnadas
Narayanan, Vijay
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
2023-11-23
Background Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cirrhotic cardiomyopathy. Few studies have addressed its clinical significance in cirrhosis. We assessed the association of LVDD with the factors affecting cirrhosis patients’ severity, complications, and survival. Methods A total of 203 cirrhosis patients were enrolled and underwent investigations, including 2-dimensional echocardiography with tissue Doppler imaging, and 139 patients with LVDD (cases) were compared with 64 patients without LVDD (controls). Logistic regression and Kaplan-Meier analysis were applied. Results Mean age was 52.76±10 years. Among LVDD patients, 56% had grade-1, and 44% had grade-2 LVDD. Cirrhosis related to NASH had a more significant association with LVDD (P<0.001) than other etiologies. LVDD was significantly associated with a greater incidence of Child-Turcotte-Pugh (CTP) class C (P<0.001), higher model for end-stage liver disease scores (P=0.001), duration of cirrhosis >2 years since diagnosis (P=0.028), ascites (P<0.001), hepatic encephalopathy (P<0.010), hepatorenal syndrome (P<0.001), and a history of obesity (P=0.004). Multivariate analysis showed that higher CTP score, ascitic fluid protein and prolonged QTc interval were independently associated with LVDD (P=0.009; P=0.018; P=0.016, respectively). Kaplan-Meier survival analysis showed significantly poorer survival status in patients with higher grades of LVDD (P<0.001). The area under the receiver operating characteristic curve (0.78) was greatest for ascitic fluid protein in predicting LVDD, with a cutoff of >1 g/dL. Conclusions Higher CTP score, prolonged QTc, higher ascitic fluid protein levels, and poor survival are significantly associated with LVDD. Ascitic fluid protein >1 g/dL could be an indicator for evaluating LVDD. Keywords Left ventricular diastolic dysfunction, cirrhosis, survival, cardiomyopathy, predictors Ann Gastroenterol 2023; 36 (6): 678-685 (EN)
Αγγλική γλώσσα
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 36, No 6 (2023); 678 (EN)
Copyright (c) 2023 Annals of Gastroenterology (EN)
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Original Articles



*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.