Which cardiac chamber is affected in different stages of liver cirrhosis

Background and aim Cirrhotic cardiomyopathy is a cardiac dysfunction manifesting in cases with cirrhosis without other known heart diseases. Cirrhotic cardiomyopathy affects up to 50% of all cirrhotic cases and typically manifests under stress. We aimed to investigate which cardiac chamber is affected in different stages of liver cirrhosis through two-dimensional (2D) strain and detect the effect of severity on left ventricular (LV), left atrium (LA), and right ventricular (RV) functions. Patients and methods The studied cases underwent complete clinical, lab research to detect the grading of liver cirrhosis, then complete TTE involving tissue doppler imaging and speckle tracking echocardiography (STE) was done to evaluate LV, RV, and LA functions. Results The liver cirrhosis cases had normal ejection fraction at rest by conventional echo. The assessment of LV diastolic function revealed marked impaired diastolic function in child C as opposed to child B and A. The LV function by 2DSTE revealed impaired function in different groups but did not reach a statistically significant value. The LA and RV function by 2DSTE was markedly impaired in all groups, particularly in child C. The multivariate analysis for independent predictors for the degree of liver cirrhosis revealed that the RVGLS has the most significant effect on high cirrhosis. Conclusion In liver cirrhosis, the LV and RV functions were normal by conventional echo. Impaired LV, RV, and LA functions by 2DSTE in liver cirrhosis cases, and the degree of impairment was highest with increasing severity of liver cirrhosis. The 2DSTE was a simple and valuable method for assessing liver cirrhosis cases and gauging its severity.