Alcoholic liver cirrhosis increases the risk of left ventricular diastolic dysfunction.

OBJECTIVES: The aim of this study was to prove that the incidence of the more unusual and largely under-researched cardiac dysfunction, i.e. diastolic, is more frequent in patients with alcoholic cirrhosis. Comparison of the incidence of left ventricular diastolic dysfunction in medical-ward patients with no prior history of cardiovascular disease to that of the patients with hepatic cirrhosis caused by alcohol abuse was carried out. The study is original from the point of view of examination of patients with cirrhosis of solely alcoholic aetiology in one Central-European university hospital.

METHODS: Three methods of echocardiographic examination were used: (i) pulse Doppler echocardiography to assess blood flow through the mitral valve and in the pulmonary veins, (ii) tissue Doppler imaging (TDI) to assess mitral annular motion, and (iii) colour M-mode Doppler echocardiography to assess blood flow from the left atrium into the left ventricle.

RESULTS: The results found confirmed that the incidence of left ventricular diastolic dysfunction in patients with alcohol-related liver cirrhosis, classified as Child-Pugh grade A and B, was significantly higher than in the controls without any prior liver disease. Furthermore, our research team has newly noticed how the severity of diastolic dysfunction affects the morbidity and mortality of patients undergoing such treatments as the transjugular intrahepatic portosystemic shunt (TIPS), liver transplantation and other surgical interventions resulting from different indications.

CONCLUSION: The high incidence of diastolic dysfunction in cirrhotic alcoholics should not be underestimated. Examination of diastolic dysfunction should be a standard procedure for making clinical decisions about these patients.