Prognostic value of two-dimensional strain-echocardiography in patients with liver cirrhosis in Intensive care Unit. A prospective, observational Study

Abstract

Purpose

Cirrhotic cardiomyopathy (CCM) is a major comorbidity of cirrhosis. The diagnostic performance of conventional echocardiography is poor. Two-dimensional-strain echo-cardiography (2D-strain) detects myocardial dysfunction earlier than conventional echocardiography, with a significant prognostic value. The aim of our study is to assess whether the 2D-strain will allow a more relevant assessment of CCM in cirrhotic patients than conventional echocardiography. The secondary objective is to determine if altered strain or strain rate are associated with cirrhotic patient's outcome in intensive care unit (ICU).

Methods

Conventional echocardiography and 2D-strain were performed on 44 consecutive patients within 24 hours of admission to the ICU. Using 2D-strain, the global-longitudinal-strain (GLS) was assessed.

Results

GLS was impaired in 64% of patients. GLS was significantly higher in the patients who died compared with those who survived, using 28-day mortality rate (-17 vs -14 p < 0.039). Regarding conventional echocardiography, no factor was associated with increased mortality.

Conclusion

GLS is correlated to cirrhotic patient's prognosis in intensive care, while conventional echocardiography shows no dysfunction.