Impact of the severity of end-stage liver disease in cardiac remodeling

Abstract

Background: The impact of end-stage liver disease (ESLD) severity in cardiac remodeling of patients with cirrhosis is unknown. Our aim was to correlate the severity of ESLD with morphologic and functional heart changes. Methods: 184 patients underwent a protocol providing data on the severity of ESLD and undergoing echocardiography to assess the diameters of the left atrium and right ventricle; the systolic and diastolic diameters of the left ventricle, interventricular septum, and posterior wall of the left ventricle; systolic pulmonary artery pressure; ejection fraction; and diastolic function. Severity of ESLD was assessed by the Model for End-Stage Liver Disease (MELD) score. Results: Left-atrial diameter (r=0.323; IC 95% 0.190-0.455; p<0.001), left-ventricular diastolic diameter (r=0.177; IC 95% 0.033-0.320; p=0.01) and systolic pulmonary artery pressure (r=0.185; IC 95% 0.036-0.335; p=0.02) significantly correlated with MELD score. Patients with MELD ≥16 had significantly higher left-atrial diameter and systolic pulmonary artery pressure, compared with patients with MELD scores <16 points. Conclusions: Changes in cardiac structure and function, as assessed by echocardiography, correlate with the severity of ESLD in patients with cirrhosis.