Table 4 Proposal for diagnostic and supportive criteria for cirrhotic cardiomyopathy
A working definition of cirrhotic cardiomyopathy
A cardiac dysfunction in patients with cirrhosis characterised by impaired contractile responsiveness to stress and/or altered diastolic relaxation with electrophysiological abnormalities in the absence of other known cardiac disease
Diagnostic criteria
Systolic dysfunction
  • Blunted increase in cardiac output on exercise, volume challenge or pharmacological stimuli

  • Resting ejection fraction <55%

Diastolic dysfunction</item></item-list>
  • E/A ratio <1.0 (age-corrected)

  • Prolonged deceleration time (>200 ms)

  • Prolonged isovolumetric relaxation time (>80 ms)

Supportive criteria</item></item-list>
  • Electrophysiological abnormalities

  • Abnormal chronotropic response

  • Electromechanical uncoupling/dys-synchrony

  • Prolonged Q–Tc interval

  • Enlarged left atrium

  • Increased myocardial mass

  • Increased BNP and pro-BNP

  • Increased troponin I

  • BNP, brain natriuretic peptide; E/A ratio, ratio of early to late (atrial) phases of ventricular filling.