Correlates of diastolic function in patients with alcoholic liver cirrhosis

Abstract

Introduction: There are few established correlations between echocardiographic and biological parameters, and the severity of hepatic alcoholic disease; and even fewer prognostic correlations. Objective: The present study is aiming at establishing correlations between severity of hepatic alcoholic disease and cardiac structural and functional alterations, as well as their prognostic implications. Method: We investigated a group of 50 patients with liver cirrhosis of alcoholic etiology, classified by Child-Pugh score. Routine laboratory tests and transthoracic echocardiography were performed, NT-proBNP level was measured in each. Results: We found that patients with more severe liver dysfunction have a significantly worse diastolic profile. The peak early diastolic filling velocity of the left ventricle (E wave) was significantly higher, with lower tissue Doppler velocities at annular level and high ratio between E and e’, which point to the severity of the diastolic dysfunction. When comparing the indexed volumes of heart cavities, we did not find significant differences regarding left atrium indexed volume, left ventricle end-diastolic or end-systolic indexed volumes. Patients with Child class B liver disease had significantly lower levels of NT-proBNP. Conclusions: This study is revealing the significant association between diastolic dysfunction of the left ventricle and severity of the alcoholic liver cirrhosis, as well as the correlation between E/e’ ratio value, Child-Pugh class and also higher values of NT-proBNP. The benefit is that patients with alcoholic cirrhosis can be also classified according to the existence and severity of left ventricular diastolic dysfunction so that these patients could benefit from a stricter monitoring and closer follow-up.