Hepatopulmonary syndrome and right ventricular diastolic functions: an echocardiographic examination.
OBJECTIVE
Liver functions are affected in the course of cardiac diseases, and similarly, liver diseases affect cardiac functions. Many studies in the literature have shown that left ventricular systolic and/or diastolic dysfunction may develop during chronic liver disease. However, there are limited studies investigating right ventricular functions during chronic liver diseases.


METHODS
A total of 84 patients who had no systolic and/or diastolic dysfunction in the left ventricle (LV) were evaluated; 46 patients with liver cirrhosis; 10 (21.74%) cirrhotic patients with hepatopulmonary syndrome (HPS) (group 1), 36 (78.26) cirrhotic patients without HPS (group 2), and 38 healthy individuals were treated as control.


RESULTS
Right ventricular diastolic dysfunction was determined in all patients of group 1 (100%), 26 of group 2 (72.22 %), and 4 of the controls (10.52%) (P<0.05). Tricuspid deceleration time (dt) was significantly different between the groups (P<0.05). In addition, right atrium (RA) diameters, right ventricle (RV) diameters, and RV wall thickness were significantly different between the groups (P<0.05). Pulmonary artery pressure (P<0.05) and pulmonary vascular resistance (P<0.05) were also seen to be higher in group 1 than those in group 2 and control group.


CONCLUSIONS
Right ventricular diastolic dysfunction rate is high in chronic liver diseases. In the presence of HPS, right ventricular diastolic dysfunction is more remarkable in patients than those without HPS. Right ventricular diastolic dysfunction may result in dilatation and hypertrophy in the right heart.
Karabulut
Aziz
A
Department of Cardiology, Division of Hepatology, University of Dicle, Diyarbakir, Turkey. azizkarabulut@hotmail.com
Iltumur
Kenan
K
Yalcin
Kendal
K
Toprak
Nizamettin
N
D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology; D015150:Echocardiography, Doppler; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000503:physiopathology*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000473:pathology; D020065:Hepatopulmonary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011651:Pulmonary Artery / Q000503:physiopathology; D011877:Radionuclide Imaging; D017678:Sex Distribution; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology; D016278:Ventricular Function, Right
D010100:Oxygen