Left ventricular diastolic function in liver cirrhosis

Background: Left ventricular systolic abnormalities have been reported in liver cirrhosis (LC). Diastolic function in cirrhotics, on the contrary, does not seem to have been studied so far. Methods: Diastolic function was evaluated in 42 cirrhotic patients and in 16 controls by means of Doppler echocardiography. Results: Compared with the controls, cirrhotics had increased left ventricular end-diastolic and left atrial volume, stroke volume, late diastolic flow velocity (peak A) (71 ± 17 cm/sec versus 56 ± 18; p < 0.01), time from onset of mitral inflow to the early peak (time E) (86 ± 11 msec versus 72 ± 14; p < 0.003), and deceleration time (DT) (194 ± 40 msec versus 159 ± 27; p < 0.001) and decreased ratio of peak E to peak A filling velocities (1.02 ± 0.35 versus 1.22 ± 0.25; p < 0.02). Patients with tense ascites had a higher E/A ratio (p < 0.03) and a shorter DT (p < 0.03) than patients with mild or no ascites. Conclusions: The impaired left ventricular relaxation in the presence of high stroke volume suggests a myocardial involvement in LC. The pseudonormalization of the E/A ratio and DT in patients with tense ascites could reflect loading conditions masking the relaxation abnormality.