A case-cohort study of left ventricular diastolic dysfunction in patients with cirrhosis: the liver-heart axis.

Autor:	Solanki R; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Sreesh S; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Attumalil TV; Department of Cardiology, CMC Vellore (Thomas Varghese Attumalil)., Mohapatra SD; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Narayanan V; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Madhu D; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Chakravorty A; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Pal R; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas)., Nair ANKK; Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala (Anjana Nalina Kumari Kesavan Nair), India., Devadas K; Department of Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala (Rushil Solanki, Srijaya Sreesh, Shivabrata dhal Mohapatra, Vijay Narayanan, Devika Madhu, Avisek Chakravorty, Ravindra Pal, Krishnadas Devadas).
Jazyk:	angličtina
Zdroj:	Annals of gastroenterology [Ann Gastroenterol] 2023 Nov-Dec; Vol. 36 (6), pp. 678-685. Date of Electronic Publication: 2023 Oct 30.
DOI:	10.20524/aog.2023.0837
Abstrakt:	Background: Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cirrhotic cardiomyopathy. Few studies have addressed its clinical significance in cirrhosis. We assessed the association of LVDD with the factors affecting cirrhosis patients' severity, complications, and survival. Methods: A total of 203 cirrhosis patients were enrolled and underwent investigations, including 2-dimensional echocardiography with tissue Doppler imaging, and 139 patients with LVDD (cases) were compared with 64 patients without LVDD (controls). Logistic regression and Kaplan-Meier analysis were applied. Results: Mean age was 52.76±10 years. Among LVDD patients, 56% had grade-1, and 44% had grade-2 LVDD. Cirrhosis related to NASH had a more significant association with LVDD (P<0.001) than other etiologies. LVDD was significantly associated with a greater incidence of Child-Turcotte-Pugh (CTP) class C (P<0.001), higher model for end-stage liver disease scores (P=0.001), duration of cirrhosis >2 years since diagnosis (P=0.028), ascites (P<0.001), hepatic encephalopathy (P<0.010), hepatorenal syndrome (P<0.001), and a history of obesity (P=0.004). Multivariate analysis showed that higher CTP score, ascitic fluid protein and prolonged QTc interval were independently associated with LVDD (P=0.009; P=0.018; P=0.016, respectively). Kaplan-Meier survival analysis showed significantly poorer survival status in patients with higher grades of LVDD (P<0.001). The area under the receiver operating characteristic curve (0.78) was greatest for ascitic fluid protein in predicting LVDD, with a cutoff of >1 g/dL. Conclusions: Higher CTP score, prolonged QTc, higher ascitic fluid protein levels, and poor survival are significantly associated with LVDD. Ascitic fluid protein >1 g/dL could be an indicator for evaluating LVDD. Competing Interests: Conflict of Interest: None (Copyright: © Hellenic Society of Gastroenterology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF