Hepatic injury in mitral valvular cardiopathy. Clinical and diagnostic aspects

: Liver function was studied in 38 patients with various types of mitral valve disease hospitalised with suspected "cardiac liver". Liver biopsy confirmed the suspicion in 22 cases including 4 with cardiac cirrhosis. The remaining 16 patients had other liver pathologies. No significant differences were noted in the distribution of symptoms, clinical signs and laboratory indices of liver function between the two groups of patients. Among instrumental examinations laparoscopy resulted in a diagnostic accuracy of 89.4% and liver echography of 73% when their results were compared with those of needle biopsy. In other words clinical and laboratory diagnosis of "cardiac liver" was found to be totally unreliable whereas, among instrumental examinations, liver echography proved to be a reasonably efficient alternative to laparoscopy. The diagnostic accuracy of this non-invasive test suggests that it should be used systematically for the screening and follow-up of this type of patients, whereas invasive investigations would be reserved for selected cases.