title: Cardiac dysfunction in cirrhosis is not associated with the severity of liver disease.
abstract: BACKGROUND
  Cirrhotic cardiomiopathy is described as the presence of cardiac dysfunction in cirrhotic patients. The aim of the study was to investigate factors associated with cardiac dysfunction in cirrhotic patients.
  
  
  METHODS
  Seventy-four cirrhotic patients and twenty-six controls performed a conventional echocardiography and Tissue Doppler Imaging (TDI) for systolic and diastolic function. Results were analyzed by using the Guidelines of American Society of Echocardiography.
  
  
  RESULTS
  In patients with cirrhosis, left ventricular end-diastolic diameter was increased (p<0.001) , peak systolic velocities were decreased (11.3±2.7 vs 13.9±1.4cm/s; p<0.001) and left atrial volumes were increased (32.7±8.3 vs 24±8.5ml, p<0.001) as well as cardiac mass (90.6±23 vs 70.5±22g/m(2), p<0.001). Forty-seven cirrhotic patients (64%) showed diastolic dysfunction at rest: grade I in 37 and grade II in 10 patients. Systolic and/or diastolic dysfunction were not influenced by a more severe liver impairment. Diastolic dysfunction was more prevalent in patients with ascites vs those without (77% vs 56%; p=0.04).
  
  
  CONCLUSIONS
  A mild diastolic dysfunction at rest is frequent in cirrhotic patients but cardiac load conditions are confounding factors in this diagnosis. We did not identify an association between severity of liver disease and cardiac dysfunction.
authors.affiliation: Gastroenterologia, Dipartimento Medicina Clinica, Sapienza Università di Roma, Italy. manuela.merli@uniroma1.it
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.forename: Angela
authors.initials: A
authors.lastname: Calicchia
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ruffa
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Pellicori
authors.forename: Oliviero
authors.initials: O
authors.lastname: Riggio
authors.forename: Michela
authors.initials: M
authors.lastname: Giusto
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
authors.forename: Concetta
authors.initials: C
authors.lastname: Torromeo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002306:Cardiac Volume; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013318:Stroke Volume; D016276:Ventricular Function / Q000502:physiology*; D055815:Young Adult