Diagnosis and Pathogenetic Mechanisms in Cirrhotic Cardiomyopathy Based on Point-of-care Echocardiography, Biomarkers and Histology

What this Trial Is About

Cirrhotic cardiomyopathy is a heart condition linked to cirrhosis that increases risks of serious complications like hepatorenal syndrome, refractory ascites, and poor response to stressors such as sepsis or bleeding. This condition leads to increased health problems and mortality. The study focuses on left ventricular diastolic dysfunction (LVDD), which is associated with worse outcomes after liver transplantation and procedures like trans-jugular intrahepatic portosystemic shunt (TIPS). Researchers aim to better understand how LVDD and cirrhotic cardiomyopathy affect critically ill patients with cirrhosis. The study involves screening critically ill cirrhotic patients admitted to the intensive care unit using point-of-care echocardiography, electrocardiography, and cardiorenal biomarker tests to identify cirrhotic cardiomyopathy and evaluate cardiac function. For patients who do not survive, researchers will perform ultrasound-guided myocardial biopsies to examine heart tissue for inflammation and fibrosis. Routine diagnostic tests include 2D echocardiography with tissue Doppler or speckle tracking and electrocardiography. Participants will undergo echocardiographic assessments including M mode, cross-sectional, and Doppler examinations. Researchers will measure aspects like heart wall thickness and ventricle size while patients lie in the left lateral position. They will also collect biomarker data and cardiac histology from consenting deceased patients. The main measure is the prevalence of cirrhotic cardiomyopathy at enrollment, with additional assessments of cardiac dysfunction severity and tissue changes. The study monitors these outcomes to better understand heart complications in critically ill cirrhotic patients.

Cirrhotic Cardiomyopathy Based on Point-of-care Echocardiography, Biomarkers and Histology