studies

944A AASLD ABSTRACTS HEPATOLOGY, October, 2015
1503
Real Time Pressure Volume Loops in Cirrhosis: Characterization
of Systolic and Diastolic Function and Validation
of Doppler Indices with the Gold Standard
Cristina Ripoll 2,1 , Raquel Yotti 3 , Yolanda Benito 3 , Diego Rincón 2 ,
Maria Vega Catalina 2 , Jaime Elizaga 3 , Javier Bermejo 3 , Rafael
Bañares 2 ; 1 Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg,
Halle (Saale), Germany; 2 Digestive Diseases, Hospital Universitario
Gregorio Marañón, IiSGM. CiberEHD, Madrid, Spain;
3 Cardiology, Hospital General Universitario Gregorio Marañón,
IiSGM, Madrid, Spain
Studies reporting abnormal left ventricular (LV) properties in
cirrhosis have frequently used load-dependent indices. Aims:
1) to evaluate systolic and diastolic LV properties with the gold
standard, LV conductance catheter, which allows obtention
of real-time pressure volume loops, 2) to test the validity of
Doppler-echocardiography indices compared to the gold standard,
3) to analyze the impact of severity of liver disease,
neurohormonal activation and beta-blocker (BB) treatment on
LV properties. Methods. Pressure-volume loops were obtained
in 9 patients with cirrhosis (Child A:3;B:2;C:4; refractory ascites:2)
in the context of liver transplant evaluation and 9 controls
undergoing LV catheterization. Invasive gold-standard systolic
(maximal elastance, Emax) and diastolic indexes (relaxation
and stiffness) were correlated to Doppler-echocardiography
indices including peak ejection intraventricular pressure difference
(EIVPD) and strain rate (SR). Gold-standard validated
Doppler indexes in cirrhosis (n=59; Child A:15;B:25;C:19;
refractory ascites:9) were compared to matched controls.
The influence of the severity of liver disease, neurohormonal
activation and BB was evaluated. Nonparametric tests were
used. IRB approval was obtained. Results: Emax correlated
only with EIPVD (r=0.75, p