Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 28, 2016; 8(3): 200-206
Published online Jan 28, 2016. doi: 10.4254/wjh.v8.i3.200
Published online Jan 28, 2016. doi: 10.4254/wjh.v8.i3.200
Cirrhotic cardiomyopathy: Isn’t stress evaluation always required for the diagnosis?
Mara Barbosa, Joana Guardado, Carla Marinho, Bruno Rosa, Isabel Quelhas, António Lourenço, José Cotter, Gastroenterology Department, Centro Hospitalar do Alto Ave, 4835 Guimarães, Portugal
Author contributions: All authors had made substantial contributions to the study; Barbosa M, Guardado J, Marinho C, Quelhas I and Cotter J participated in the study concept and design; Barbosa M, Guardado J, Rosa B and Quelhas I were involved in acquisition, analysis and interpretation of the data; Barbosa M, Guardado J and Rosa B performed statistical analysis; Barbosa M and Guardado J drafted the manuscript; Marinho C, Quelhas I, Lourenço A and Cotter J reviewed the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of Centro Hospitalar do Alto Ave, Guimarães, Portugal.
Informed consent statement: Written informed consent was obtained from every patient included in the study.
Conflict-of-interest statement: Bruno Rosa is a consultant for Given Imagin®. Mara Barbosa, Joana Guardado, Carla Marinho, Isabel Quelhas, António Lourenço and José Cotter certify that they have NO conflit-of-interest.
Data sharing statement: Technical appendix, statistical code, dataset is available from the corresponding at maraisabelbarbosa@net.sapo.pt. Consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mara Barbosa, MD, Gastroenterology Department, Centro Hospitalar do Alto Ave, Rua dos Cutileiros, Creixomil, 4835 Guimarães, Portugal. maraisabelbarbosa@net.sapo.pt
Telephone: +351-933-112632 Fax: +351-253-513592
Received: October 12, 2015
Peer-review started: October 14, 2015
First decision: November 11, 2015
Revised: December 2, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: January 28, 2016
Peer-review started: October 14, 2015
First decision: November 11, 2015
Revised: December 2, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: January 28, 2016
Core Tip
Core tip: Our study demonstrates that cirrhotic cardiomyopathy (CCM) is a frequent condition that is independent of the severity of liver disease. Furthermore, it shows that CCM is currently underdiagnosed, even after a comprehensive evaluation at rest. Consequently, a stress test should always be considered in the diagnostic approach to CCM, as it is here. Moreover, an association between corrected QT (QTc) interval prolongation and the presence of gastroesophageal varices was revealed, irrespective of the diagnosis of CCM. As such, the clinical significance of QTc interval prolongation is emphasized and it can be regarded as a marker of severe liver disease.