Cirrhotic cardiomyopathy: a subject that's always topical

Figures & data

Table 1. World Congress of Gastroenterology in Montreal in 2005's criteria defining cirrhotic cardiomyopathy.

Diagnostic criteria:   – Abnormal contractile systolic response to stress   – Diastolic dysfunction at rest   – Absence of significant cardiopulmonary abnormality

Systolic dysfunction: at least one of the following two criteria:   – Increase in cardiac output attenuated by exercise, or in the event of volemic or pharmacological stress   – Resting ejection fraction <50%. Absence of signs of heart failure at rest

Diastolic dysfunction   – E/A <1 (age corrected)   – E wave deceleration time >200 ms   – Prolonged isovolumic relaxation time >80 ms

Additional criteria:   – Electrophysiological abnormalities   – Abnormal chronotropic response   – Prolongation of QTc interval   – Autonomic dysfunction   – Enlarged left atrium   – Increased myocardial mass and LV wall thickness   – Increased pro BNP, BNP, ANP and troponin   – QT interval prolongation

ANP: Atrial natriuretic peptide; A: Wave A (atrial); BNP: Brain natriuretic peptide; E: Wave E (early); LV: Left ventricle.

Figure 1. New criteria defining cirrhotic cardiomyopathy.

A: Atrial wave; E: Early wave; LA: Left Atrial TR: Tricuspid regurgitation.

Figure 2. Physiopathology of cirrhotic cardiomyopathy.

RAS: Renin angiotensin system.