Cirrhotic cardiomyopathy: Implications for the perioperative management of liver transplant patients

Table 2 2005 World Congress of Gastroenterology diagnostic and supportive criteria for cirrhotic cardiomyopathy[1]

A working definition of cirrhotic cardiomyopathy

A cardiac dysfunction in patients with cirrhosis characterised byimpaired contractile responsiveness to stress and/or altered diastolicrelaxation with electrophysiological abnormalities in the absence ofother known cardiac disease

Diagnostic criteria

Systolic dysfunction

Blunted increase in cardiac output on exercise, volume challenge orpharmacological stimuli

Resting LVEF < 55%

Diastolic dysfunction

E/A ratio < 1 (age-corrected)

Prolonged deceleration time (> 200 ms)

Prolonged isovolumetric relaxation time (> 80 ms)

Supportive criteria

Electrophysiological abnormalities

Abnormal chronotropic response

Electromechanical uncoupling

Prolonged QTc interval

Enlarged left atrium

Increased myocardial mass

Increased BNP (brain natriuretic peptide) and pro-BNP

Increased troponinI

BNP: B-type natriuretic peptide; LVEF: Left ventricular ejection fraction.