Decreased right heart blood volume determined by magnetic resonance imaging: evidence of central underfilling in cirrhosis.

Whether the central blood volume is reduced or expanded in cirrhosis is still under debate. Accordingly, the current study was undertaken to assess the volume of the heart cavities. Ten cirrhotic patients and matched controls had their right and left ventricular end-diastolic volumes (RVDV and LVDV), and end-systolic volumes (RVSV and LVSV) determined by magnetic resonance imaging (MRI). RVDV (122 vs. control 166 mL, P < .02), RVSV (41 vs. 80 mL, P < .02) and right atrial volume (47 vs. 64 mL, P < .05) were significantly reduced in the patients. In contrast, LVDV (134 vs. 129 mL, NS), LVSV (54 vs. 40 mL, NS), and left atrial volume (70 vs. 57 mL, P = .08) were normal or slightly increased. The right ejection fraction (68% vs. 53%, P < .05) was significantly increased, but the left ejection fraction was slightly reduced (61% vs. 69%, NS). The central and arterial blood volume (CBV), assessed as the cardiac output (CO) multiplied by the central circulation time, was significantly decreased (1.47 vs. 1.81 L, P < .05). The noncentral blood volume (4.43 vs. 3.64 L, P < .02), plasma volume (4.05 vs. 3.27 L, P < .02), and CO (7.11 vs. control 5.22 L/min, P < .01) were significantly increased in the patients. CCT (13.1 vs. 20.0 sec, P < .005) and the right ventricular transit time (0.79 vs. 1.35 sec, P < .005) were significantly reduced, but the left ventricular transit time was normal (0.91 vs. 0.88 sec, NS). Systemic vascular resistance was reduced (991 vs. 1,490 dyn.sec/cm5, P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)