Combined Systolic Velocities Using Tissue Doppler Imaging Could Predict the Severity of Cirrhosis: a Prospective Cohort Study

Overview

Journal Cardiovasc J Afr

Specialty Cardiology & Vascular Diseases

Date 2023 Aug 1

PMID 37526978

Authors

Ibrahim Donmez

Emrah Acar

Affiliations

Soon will be listed here.

Abstract

Aim: Recent research has demonstrated that the contractile characteristics of the right ventricular outflow tract (RVOT) play a significant role in right ventricular function. Pulmonary annular motion velocity (PAMVUT) is a reliable marker of RVOT function. Also, combined systolic velocity [PAMVUT added to tricuspid annular systolic velocity (St)] has been revealed as a suitable parameter for right ventricular systolic function. In this study, we examined the association between the severity of the illness in cirrhotic patients and the combined S velocities (CSV).

Methods: Seventy-four patients with cirrhosis went to the echocardiography laboratory of the Cardiology Department in our centre. Traditional echocardiographic measurements, PAMVUT and CSV values were recorded. The Child-Pugh classes of the patients were determined.

Results: Receiver operating characteristic curve analysis demonstrated that a CSV of 23 cm/s constituted the cut-off value for predicting a moderate-to-severe form of cirrhosis with 76% sensitivity and 65.3% specificity (area uder the curve = 0.735, < 0.001).

Conclusion: CSV values could predict the severity of cirrhosis more precisely than traditional right ventricular systolic function parameters.

References

Popescu B, Beladan C, Popescu A . Diastolic Function Assessment Revisited: Is Big Data Analysis Going to be a Big Hit?. JACC Cardiovasc Imaging. 2018; 12(7 Pt 1):1162-1164. DOI: 10.1016/j.jcmg.2018.03.027. View

Alsoos F, Almobarak M, Shebli H . Right ventricular outflow tract systolic excursion: a useful method for determining right ventricular systolic function. J Echocardiogr. 2016; 12(4):151-8. DOI: 10.1007/s12574-014-0229-x. View

Izzy M, VanWagner L, Lin G, Altieri M, Findlay J, Oh J . Redefining Cirrhotic Cardiomyopathy for the Modern Era. Hepatology. 2019; 71(1):334-345. PMC: 7288530. DOI: 10.1002/hep.30875. View

Hayabuchi Y, Ono A, Homma Y, Kagami S . Pulmonary annular motion velocity reflects right ventricular outflow tract function in children with surgically repaired congenital heart disease. Heart Vessels. 2017; 33(3):316-326. DOI: 10.1007/s00380-017-1061-9. View

Sampaio F, Pimenta J, Bettencourt N, Fontes-Carvalho R, Silva A, Valente J . Systolic and diastolic dysfunction in cirrhosis: a tissue-Doppler and speckle tracking echocardiography study. Liver Int. 2013; 33(8):1158-65. DOI: 10.1111/liv.12187. View

Lang R, Bierig M, Devereux R, Flachskampf F, Foster E, Pellikka P . Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of.... J Am Soc Echocardiogr. 2005; 18(12):1440-63. DOI: 10.1016/j.echo.2005.10.005. View

Lang R, Badano L, Mor-Avi V, Afilalo J, Armstrong A, Ernande L . Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015; 16(3):233-70. DOI: 10.1093/ehjci/jev014. View

Zamirian MD M, Samiee MD E, Moaref MD A, Abtahi MD F, Tahamtan MD M . Assessment of Subclinical Myocardial Changes in Non-Alcoholic Fatty Liver Disease: A Case-Control Study Using Speckle Tracking Echocardiography. Iran J Med Sci. 2018; 43(5):466-472. PMC: 6123551. View

Setoyama K, Sonoda S, Naka Y, Okabe H, Inoue K, Miura T . Right ventricular branch compromise after percutaneous coronary intervention and baseline chronic kidney disease: A high-risk combination associated with long-term prognoses in acute inferior myocardial infarction. J Cardiol. 2021; 78(5):463-470. DOI: 10.1016/j.jjcc.2021.06.005. View

10.

Xanthopoulos A, Starling R, Kitai T, Triposkiadis F . Heart Failure and Liver Disease: Cardiohepatic Interactions. JACC Heart Fail. 2018; 7(2):87-97. DOI: 10.1016/j.jchf.2018.10.007. View

11.

Haddad F, Hunt S, Rosenthal D, Murphy D . Right ventricular function in cardiovascular disease, part I: Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008; 117(11):1436-48. DOI: 10.1161/CIRCULATIONAHA.107.653576. View

12.

Xanthouli P, Miazgowski J, Benjamin N, Gordjani O, Egenlauf B, Harutyunova S . Prognostic meaning of right ventricular function and output reserve in patients with systemic sclerosis. Arthritis Res Ther. 2022; 24(1):173. PMC: 9306074. DOI: 10.1186/s13075-022-02863-1. View

13.

Cengiz Elcioglu B, Baydar O, Helvaci F, Karatas C, Aslan G, Kilic A . Evaluation of pulmonary arterial stiffness and comparison with right ventricular functions in patients with cirrhosis preparing for liver transplantation. J Clin Ultrasound. 2022; 50(6):749-755. DOI: 10.1002/jcu.23234. View

14.

Heidelbaugh J, Sherbondy M . Cirrhosis and chronic liver failure: part II. Complications and treatment. Am Fam Physician. 2006; 74(5):767-76. View

15.

Oz A, Cinar T, Tas E, Efe S, Ayca B, Karabag T . Assessment of pulmonary arterial stiffness in patients with cirrhosis: A prospective cohort study. Echocardiography. 2020; 38(1):57-63. DOI: 10.1111/echo.14935. View

16.

Spann A, Coe C, Ajayi T, Montgomery G, Shwetar M, Oje A . Cirrhotic cardiomyopathy: Appraisal of the original and revised criteria in predicting posttransplant cardiac outcomes. Liver Transpl. 2022; 28(8):1321-1331. PMC: 9288516. DOI: 10.1002/lt.26460. View

17.

Carvalheiro F, Rodrigues C, Adrego T, Viana J, Vieira H, Seco C . Diastolic Dysfunction in Liver Cirrhosis: Prognostic Predictor in Liver Transplantation?. Transplant Proc. 2016; 48(1):128-31. DOI: 10.1016/j.transproceed.2016.01.010. View

18.

Zhang K, Braun A, von Koeckritz F, Schmuck R, Teegen E, Cuspidi C . Right Heart Remodeling in Patients with End-Stage Alcoholic Liver Cirrhosis: Speckle Tracking Point of View. J Clin Med. 2019; 8(9). PMC: 6780282. DOI: 10.3390/jcm8091285. View

19.

von Kockritz F, Braun A, Schmuck R, Dobrindt E, Eurich D, Heinzel F . Speckle Tracking Analysis Reveals Altered Left Atrial and Ventricular Myocardial Deformation in Patients with End-Stage Liver Disease. J Clin Med. 2021; 10(5). PMC: 7956617. DOI: 10.3390/jcm10050897. View

20.

Rimbas R, Baldea S, Guerra R, Visoiu S, Rimbas M, Pop C . New Definition Criteria of Myocardial Dysfunction in Patients with Liver Cirrhosis: A Speckle Tracking and Tissue Doppler Imaging Study. Ultrasound Med Biol. 2018; 44(3):562-574. DOI: 10.1016/j.ultrasmedbio.2017.11.013. View