Doppler Echocardiographic Assessment of Left Ventricular Diastolic Function in Cirrhotic Patients

In 16 patients with clinical and histopathological diagnosis of liver cirrhosis and ascites, left ventricular diastolic function was assessed by pulsed Doppler echocardiography before and after paracentesis, and the results were compared with those obtained from 15 healthy subjects. In healthy subjects, mean values of mitral early filling velocity (E) and veloccity after atrial contraction (A) were 59.7±1.6 and 44.2±1.4 cm/sec, respectively. In cirrhotic patients, before paracentesis, the mean E and A wave velocities were found to be 52.64±3.4 and 64.4±3.2 cm/sec respectively. In these patients, A veloity was found to be significantly higher (p<0.05) than controls, without significant differencces in E velocity values, suggesting the presence of diastolic dysfunction in cirrhotic patients. After paracentesis, E and A wave velocities were found to be 54.68±0.07 and 64.94±0.03 cm/sec, respectively. No statistically significant change was observed in these velocities with paracentesis. In conclusion left ventricular diastolic function was found impaired in cirrhotic patients and not altered by paracentesis suggesting the possible role of some neurohumoral and metabolic factors rather than volume overloading.