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

Soon Kyu LEE; Myeong Jun SONG; Seok Hwan KIM; Hyo Jun AHN

Return

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

Author: Soon Kyu LEE ¹ ; Myeong Jun SONG ; Seok Hwan KIM ; Hyo Jun AHN
Author Information

1. Division of Hepatology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea. mjsong95@gmail.com
Publication Type:Original Article
Keywords: Liver cirrhosis; Diastolic heart failure; Cardiomyopathies; Echocardiography
MeSH: Ascites; Cardiomyopathies; Diagnosis; Echocardiography; Esophageal and Gastric Varices; Follow-Up Studies; Heart Failure, Diastolic; Humans; Liver Cirrhosis*; Liver*; Multivariate Analysis; Prognosis*; Prospective Studies; Survival Rate
From:Clinical and Molecular Hepatology 2018;24(4):409-416
CountryRepublic of Korea
Language:English
Abstract: BACKGROUND/AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: The presence of LVDD is associated with poor survival in patients with decompensated LC. Therefore, it may be important to monitor and closely follow LVDD patients.