title: Diastolic dysfunction is associated with low urinary sodium excretion in patients with decompensated cirrhosis.
abstract: OBJECTIVE
  The pathogenesis and the clinical impact of diastolic dysfunction (DD) in cirrhosis remain unclear. Our aim was to investigate the factors significantly associated with the presence of DD in patients with decompensated cirrhosis on the waiting list for liver transplantation.
  
  
  METHODS
  consecutive patients with decompensated cirrhosis, who admitted for transplant assessment, were prospectively evaluated. We assessed the independent factors associated with the presence of DD, while their discriminative ability was evaluated by AUC curve. The diagnosis of DD was based on Doppler echocardiography and classified into three categories according to the current guidelines.
  
  
  RESULTS
  we evaluated 115 consecutive patients. Sixty six patients (57.3%-group 1) had DD and 49 (42.7%-group 2) had not DD. The 2 groups had similar Child-Pugh/MELD scores and survival. In multivariable logistic regression analysis, pulse rate (OR: 1.082, 95% CI: 1.03-1.15, p = 0.004), and UNa24h (OR: 0.98, 95% CI: 0.97- 0.99, p = 0.004) were the only variables independently associated with the presence of DD. In the subgroup of consecutive patients (n = 31) with evaluation of cytokines, those (n = 22) with DD, compared to those (n = 9) without DD, had significantly higher levels of inteleukin-6 [145 (45-2000) vs. 56 (10-149)pg/mL, p = 0.043].
  
  
  CONCLUSIONS
  We found that DD was independently associated with lower 24-hour urine sodium. Although no correlation was found between DD and severity of liver disease or survival, further studies are needed for final conclusions.
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Evangelos
authors: E
authors: Cholongitas
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Ioannis
authors: I
authors: Goulis
authors: Third Cardiology Department, Hippokration Hospital, Medical School, Aristotle University of Thessaloniki, Greece.
authors: Efstathios
authors: E
authors: Pagourelias
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Charis
authors: C
authors: Birtsou
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Maria
authors: M
authors: Ioannidou
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Maria
authors: M
authors: Ioannidou
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Parthenis
authors: P
authors: Chalevas
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Stergios
authors: S
authors: Soulaidopoulos
authors: Third Cardiology Department, Hippokration Hospital, Medical School, Aristotle University of Thessaloniki, Greece.
authors: Vasilios
authors: V
authors: Vassilikos
authors: 4th Department of Internal Medicine, Hippokration General Hospital, Medical School Aristotle University of Thessaloniki, Greece.
authors: Evangelos
authors: E
authors: Akriviadis
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007668:Kidney / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009318:Natriuresis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D065667:Renal Elimination; D012307:Risk Factors; D012720:Severity of Illness Index; D012964:Sodium / Q000652:urine*; D016482:Urinalysis; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D014850:Waiting Lists
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D012964:Sodium