title: A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation.
abstract: BACKGROUND
  Cirrhosis has been shown to be associated with left ventricular (LV) myocardial dysfunction, but studies of right ventricular (RV) function in cirrhotic patients compared with controls are scarce. Limited studies have prospectively evaluated the progression of myocardial function in patients with cirrhosis and assessed changes in cardiac function following liver transplantation (LTx). So the aim of the study was to evaluate biventricular myocardial function in cirrhotic patients and its alteration with or without liver transplantation.
  
  
  METHODS
  A total of 103 patients with cirrhosis (age 55±7 years, male 75%) were recruited. Conventional and 2-dimensional speckle tracking echocardiography was performed to determine the presence of LV and RV (biventricular) dysfunction. For comparison, 48 matched control subjects were included. Follow-up echocardiography was performed in 41 patients following LTx and in 26 patients who did not undergo LTx.
  
  
  RESULTS
  Patients with cirrhosis had biventricular dilatation, increased LV mass, impaired LV diastolic function, and biventricular systolic strain compared with controls. Following LTx, cirrhotic patients had reduced biventricular dilatation, a smaller LV mass, and improved biventricular systolic strain after a mean duration of 18.2±6.6 months. Patients who did not undergo LTx had a further increase in LV mass but no significant change in biventricular dimensions or systolic strain (mean duration of 20.4±8.3 months).
  
  
  CONCLUSIONS
  The present study demonstrates that patients with cirrhosis had biventricular dilatation and impaired biventricular systolic strain compared with controls. Following LTx, biventricular dilatation reduced and biventricular systolic strain improved. In contrast, patients who did not undergo LTx experienced a further increase in LV mass.
authors: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors: Yan
authors: Y
authors: Chen
authors: Division of Surgery, The University of Hong Kong, Hong Kong, China.
authors: Albert C
authors: AC
authors: Chan
authors: Division of Surgery, The University of Hong Kong, Hong Kong, China.
authors: See-Ching
authors: SC
authors: Chan
authors: Division of Surgery, The University of Hong Kong, Hong Kong, China.
authors: Siu-Ho
authors: SH
authors: Chok
authors: Division of Surgery, The University of Hong Kong, Hong Kong, China.
authors: William
authors: W
authors: Sharr
authors: Division of Surgery, The University of Hong Kong, Hong Kong, China.
authors: James
authors: J
authors: Fung
authors: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors: Ju-Hua
authors: JH
authors: Liu
authors: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors: Zhe
authors: Z
authors: Zhen
authors: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors: Wai-Ching
authors: WC
authors: Sin
authors: Division of Surgery, The University of Hong Kong, Hong Kong, China.
authors: Chung-Mau
authors: CM
authors: Lo
authors: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Electronic address: hftse@hku.hk.
authors: Hung-Fat
authors: HF
authors: Tse
authors: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China; Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Electronic address: khkyiu@hku.hk.
authors: Kai-Hang
authors: KH
authors: Yiu
mesh_terms: D003971:Diastole; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
keywords: Cardiac function; Cirrhosis; Liver transplantation