TY - JOUR

T1 - Association of low mechano-energetic efficiency and prognosis in liver cirrhosis

AU - Sjöstedt, Sannia

AU - Wiese, Signe

AU - Bendtsen, Flemming

AU - Møller, Søren

N1 - Publisher Copyright: © 2022 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

PY - 2023

Y1 - 2023

N2 - Background: In cirrhosis, cardiac systolic dysfunction as part of cirrhotic cardiomyopathy affects prognosis. Myocardial mechano-energetic efficiency (MEE) is an estimate of left ventricular performance. In this study we investigated the relation of MEE to patient characteristics and its impact on survival in patients with cirrhosis. Patients and Methods: We included 283 patients with cirrhosis of different severity according to the Child−Pugh classifications (A/B/C: 106/87/90). All patients had a liver vein catheterization and a hemodynamic investigation performed including determination of cardiac output (CO), stroke volume and heart rate (HR). These data were used to assess MEE, which was defined as (stroke volume/HR) × 1.666. Results: Eighty-nine percent of patients had portal hypertension (hepatic venous pressure gradient >5 mmHg) and 80% indications of hyperdynamic circulatory state (increased CO and HR). There was no difference in MEE in Child−Pugh class C patients (2.03) versus Child−Pugh class A (1.98) and B (2.05) patients. In Child−Pugh class C patients, low MEE was associated with a poorer prognosis. Conclusion: In our study, MEE does not seem to be associated with severity of the liver disease, but in patients with advanced disease low MEE is associated with a poorer prognosis. The prognostic impact of MEE should be further investigated.

AB - Background: In cirrhosis, cardiac systolic dysfunction as part of cirrhotic cardiomyopathy affects prognosis. Myocardial mechano-energetic efficiency (MEE) is an estimate of left ventricular performance. In this study we investigated the relation of MEE to patient characteristics and its impact on survival in patients with cirrhosis. Patients and Methods: We included 283 patients with cirrhosis of different severity according to the Child−Pugh classifications (A/B/C: 106/87/90). All patients had a liver vein catheterization and a hemodynamic investigation performed including determination of cardiac output (CO), stroke volume and heart rate (HR). These data were used to assess MEE, which was defined as (stroke volume/HR) × 1.666. Results: Eighty-nine percent of patients had portal hypertension (hepatic venous pressure gradient >5 mmHg) and 80% indications of hyperdynamic circulatory state (increased CO and HR). There was no difference in MEE in Child−Pugh class C patients (2.03) versus Child−Pugh class A (1.98) and B (2.05) patients. In Child−Pugh class C patients, low MEE was associated with a poorer prognosis. Conclusion: In our study, MEE does not seem to be associated with severity of the liver disease, but in patients with advanced disease low MEE is associated with a poorer prognosis. The prognostic impact of MEE should be further investigated.

KW - ascites

KW - cardiac dysfunction

KW - cirrhotic cardiomyopathy

KW - hemodynamics

KW - hyperdynamic circulation

KW - liver disease

KW - liver failure

KW - portal hypertension

U2 - 10.1111/cpf.12789

DO - 10.1111/cpf.12789

M3 - Journal article

C2 - 36149083

AN - SCOPUS:85139529027

VL - 43

SP - 28

EP - 32

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

IS - 1

ER -