Diastolic Dysfunction – Negative Prognostic Factor in Patients With Hepatic Cirrhosis

Abstract

Objectives. To evaluate the left ventricular diastolic function in patients with cirrhosis and to establish its relation to the degree of severity of liver disease as well as to biological markers of cardiac dysfunction. Methods. We included 72 patients diagnosed with liver cirrhosis in different degrees of disease progression. Cardiac parameters were evaluated by two-dimensional echocardiography and color Doppler. Results. In terms of diastolic echocardiographic function, 26 patients had normal diastolic function, 36 had grade 1 diastolic dysfunction, 8 had grade 2 dysfunction, and 2 patients had grade 3. Diastolic dysfunction was unrelated to age, gender and etiology of cirrhosis. Of all the echocardiographic parameters, left ventricular hypertrophy, right cavity dimensions, E wave deceleration time, left atrial volume were significantly higher in patients with diastolic dysfunction, correlated with the severity of cirrhosis. Significantly elevated NT-proBNP and TnI were seen among the patients with diastolic dysfunction. Conclusions. The present study shows that although diastolic dysfunction is common in cirrhosis, it is usually incipient and most often correlates with the severity of the liver disease (Child-Pugh class).