Heart Failure Reviews

, Volume 21, Issue 5, pp 599–610 | Cite as

Diastolic dysfunction in cirrhosis

  • Søren MøllerEmail author
  • Signe Wiese
  • Hanne Halgreen
  • Jens D. Hove


Development of esophageal varices, ascites, and hepatic nephropathy is among the major complications of cirrhosis. The presence of cirrhotic cardiomyopathy, which includes a left ventricular diastolic dysfunction (DD), seems to deteriorate the course of the disease and the prognosis. Increased stiffness of the cirrhotic heart may decrease the compliance and result in DD. The prevalence of DD in cirrhotic patients averages about 50 %. It can be evaluated by transmitral Doppler echocardiography, tissue Doppler echocardiography, and cardiac magnetic resonance imaging. There seems to be a relation between DD and the severity of liver dysfunction and the presence of ascites. After liver transplantation, DD worsens the prognosis and increases the risk of graft rejection, but DD improves after few months. Insertion of a transjugular intrahepatic portosystemic shunt increases left ventricular diastolic volumes, and DD is a predictor of poorer survival in these patients. Future studies should aim at disclosing pathophysiological mechanisms behind the developing of DD in cirrhosis in relation to patient characteristics, development of complications, treatment, and risk associated with interventional procedures.


Cirrhotic cardiomyopathy Hyperdynamic syndrome Systolic dysfunction Cardiac dysfunction Vasodilatation 



Atrial contribution


Atrial natriuretic peptide


Brain natriuretic peptide


Baroreflex sensitivity


Calcitonin gene-related peptide


Cardiac magnetic resonance imaging


Left ventricular diastolic dysfunction


Diastolic deceleration time




Isovolumetric relaxation phase


Isovolumetric relaxation time


Left ventricular ejection fraction


Model of end-stage liver disease


Post-paracentesis-induced circulatory dysfunction


Renin–angiotensin–aldosterone system


Rapid filling


Slow filling


Transjugular portosystemic shunt


Tumor necrosis factor



SM received a research grant from the Novo Nordisk Foundation.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Søren Møller
    • 1
    Email author
  • Signe Wiese
    • 1
  • Hanne Halgreen
    • 1
  • Jens D. Hove
    • 2
  1. 1.Department of Clinical Physiology and Nuclear Medicine 260, Centre for Functional Imaging and Research, Faculty of Health Sciences, Hvidovre HospitalUniversity of CopenhagenCopenhagenDenmark
  2. 2.Department of Cardiology, Faculty of Health Sciences, Hvidovre HospitalUniversity of CopenhagenCopenhagenDenmark

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