Left ventricular diastolic function in liver cirrhosis.
BACKGROUND
Left ventricular systolic abnormalities have been reported in liver cirrhosis (LC). Diastolic function in cirrhotics, on the contrary, does not seem to have been studied so far.


METHODS
Diastolic function was evaluated in 42 cirrhotic patients and in 16 controls by means of Doppler echocardiography.


RESULTS
Compared with the controls, cirrhotics had increased left ventricular end-diastolic and left atrial volume, stroke volume, late diastolic flow velocity (peak A) (71 + or - 17 cm/sec versus 56 +/- 18; p <0.01), time from onset of mitral inflow to the early peak (time E) (86 + or - 11 msec versus 72 +/- 14; p < 0.003), and deceleration time (DT) (194 +/- 40 msec versus 159 +/- 27; p < 0.001) and decreased ratio of peak E to peak A filling velocities (1.02 +/ - 0.35 versus 1.22 +/- 0.25; p < 0.02). Patients with tense ascites had a higher E/A ratio (p < 0.03) and a shorter DT (p < 0.03) than patients with mild or no ascites.


CONCLUSIONS
The impaired left ventricular relaxation in the presence of high stroke volume suggests a myocardial involvement in LC. The pseudo normalization of the E/A ratio and DT in patients with tense ascites could reflect loading conditions masking the relaxation abnormality.
Finucci
G
G
Dept. of Clinical Medicine, University of Padua, Italy.
Desideri
A
A
Sacerdoti
D
D
Bolognesi
M
M
Merkel
C
C
Angeli
P
P
Gatta
A
A
D001201:Ascites / Q000150:complications; D001794:Blood Pressure; D002302:Cardiac Output; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left