Key result
End-stage liver disease was associated with significantly increased left ventricular longitudinal strain and reduced left atrial reservoir and conduit strain compared to controls.
Why the study?
Cardiac function can be influenced by liver cirrhosis and requires thorough evaluation before liver transplantation, but left ventricular and left atrial strain had not been fully evaluated.
Does speckle tracking echocardiography detect altered left atrial and ventricular myocardial deformation in patients with end-stage liver disease compared to controls?
Cross-Sectional (n=110)
Does speckle tracking echocardiography detect altered left atrial and ventricular myocardial deformation in patients with end-stage liver disease compared to controls?
Speckle tracking echocardiography is more sensitive than conventional volumetric methods for detecting early left ventricular and atrial myocardial deformation changes in patients with end-stage liver disease.
May inform pre-transplant cardiac assessment in cirrhosis; leaves open its prognostic value.
BACKGROUND: Cardiac function can be influenced by liver cirrhosis and should be thoroughly evaluated before liver transplantation. We investigated left ventricular (LV) and, for the first time, left atrial (LA) strain and strain rate in end-stage liver cirrhosis patients of different etiologies. METHODS: This retrospective, cross-sectional study evaluated left heart function in 80 cirrhosis patients and 30 controls using standardized echocardiographic techniques and speckle tracking technology (STE) analysis. Serum markers of liver function were used for correlation analysis. RESULTS: While conventional parameters demonstrated no alteration in systolic function, speckle tracking analysis showed a significant increase in LV longitudinal strain throughout all cardiac layers, with significant correlation to model of end-stage liver disease (MELD) score. LA reservoir and conduit strain as well as LA strain rate in all phases were significantly reduced in end-stage liver disease (ESLD) patients compared to control. STE for the evaluation of LA phasic function seemed to be more sensitive than volumetric methods. Kaplan-Meier curves showed a trend towards reduced post-transplant survival in patients with a reduced LA reservoir and conduit strain. CONCLUSION: STE analysis detected increased LV and decreased LA deformation in cirrhosis patients, thus proving to be highly sensitive to cardiac changes and useful for more precise cardiac evaluation.
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Köckritz et al. (2021) conducted a cross-sectional in End-stage liver disease (cirrhosis) (n=110). End-stage liver disease vs. Healthy controls was evaluated on Left ventricular (LV) and left atrial (LA) strain and strain rate. End-stage liver disease was associated with significantly increased left ventricular longitudinal strain and reduced left atrial reservoir and conduit strain compared to controls.
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