Characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction

Yichen YAO; Haiyu WANG; Lin DAI; Qian WANG; Ranran XI; Junting WAN; Jinjun CHEN

doi:10.12449/JCH250816

Volume 41 Issue 8

Aug. 2025

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Article Navigation > Journal of Clinical Hepatology > 2025 > 41(8): 1571-1578

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Characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction

DOI: 10.12449/JCH250816

Yichen YAO^1a,
Haiyu WANG^1a,
Lin DAI^1b,
Qian WANG^1b,
Ranran XI^1b,
Junting WAN^1b,
Jinjun CHEN^{1a, 2, 3
,
,
,}

1a.
Department of Infectious Disease Nanfang Hospital，Southern Medical University，Guangzhou 510515，China
1b.
Ultrasound Department，Hepatology Unit Nanfang Hospital，Southern Medical University Guangzhou 510515，China
2.
Hepatology Unit，Zengcheng Branch of Nanfang Hospital，Southern Medical University，Guangzhou 511300，China
3.
Hepatology Institute of Guangdong Province，Guangzhou 510515，China

Research funding:

National Key Research and Development Program of China (2022YFC2304800);

National Natural Science Foundation of China (82370614)

More Information

Corresponding author: CHEN Jinjun， chjj@smu.edu.cn （ORCID： 0000-0003-4275-9149）
Received Date: 2024-12-09
Accepted Date: 2025-01-13
Published Date: 2025-08-25

Abstract

Abstract

Objective To retrospectively study the characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction， and to inform the clinical diagnosis and treatment of decompensated liver cirrhosis. Methods We retrospectively analyzed the clinical data of patients with liver cirrhosis and diastolic heart dysfunction admitted to Nanfang Hospital of Southern Medical University from April 1， 2019 to July 31， 2023. The patients were divided into compensated cirrhosis group （n=37） and decompensated cirrhosis group （n=226）， and those with decompensated cirrhosis were further divided into subgroups of patients with heart dysfunction （n=84） and patients without heart dysfunction （n=142）. We compared two groups using the independent samples t-test and Mann-Whitney U test for continuous data in normal distribution and data in skewed distribution， respectively； compared multiple groups using the Kruskal-Wallis H test， with subsequent paired comparisons using the Wilcoxon test； compared categorical data between two groups using the chi-square test or corrected chi-square test； identified the factors affecting patient survival using a Logistic regression model； and plotted Kaplan-Meier survival curves， with inter-group comparisons using the log-rank test. Results A total of 263 eligible patients were ultimately included， among whom 226 patients were diagnosed with decompensated liver cirrhosis （84 patients with diastolic dysfunction）. Between the diastolic dysfunction group and non-diastolic dysfunction group， significant differences were detected in age （t=-4.566，P<0.05）， activated partial thromboplastin time （Z=-3.026，P<0.05）， prothrombin time （Z=-2.450，P<0.05）， international normalized ratio （Z=2.779，P<0.05）， and the proportion of moderate esophageal varices （χ²=4.273，P<0.05）. During hospitalization， 35 patients experienced new or aggravated ascites （18 with cardiac dysfunction and 17 without cardiac dysfunction）， 6 patients experienced new gastroesophageal variceal bleeding， and 9 patients experienced new or aggravated hepatic encephalopathy （3 with cardiac dysfunction and 6 without cardiac dysfunction）. Jaundice was the most common decompensation event upon admission， and electrophysiological abnormalities were the most common electrocardiogram findings upon admission. During the 90-day follow-up period， 30 individuals （12 with cardiac dysfunction and 18 without cardia dysfunction） died. The logistic regression analysis showed that age （odds ratio［OR］=1.075， 95% confidence interval［CI］：1.033 ‍— ‍1.119，P<0.001）， N-terminal pro-B-type natriuretic peptide （NT-proBNP，OR=0.996，95%CI：0.992 ‍— ‍0.999，P=0.016）， and mild/moderate ascites （OR=0.270，95%CI：0.092 ‍— ‍0.789，P=0.017） were independent predictive factors for cirrhotic cardiomyopathy. Conclusion Timely attention should be paid to elderly patients with decompensated liver cirrhosis and diastolic heart dysfunction who have a decline in NT-proBNP and mild to moderate ascites. Symptomatic treatment such as diuretics may improve diastolic heart dysfunction.
- Liver Cirrhosis,
- Heart Failure,
- Diastolic,
- Acute-On-Chronic Liver Failure

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References

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Characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction

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Characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction

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