Response to Drs. Piscaglia et al.

TO THE EDITOR: In their letter Piscaglia and coworkers suggest that the abnormalities in cardiac function reported in our article "Modification of Cardiac Function in Cirrhotic patients With and Without Ascites" (1) could be influenced by the origin of liver disease. In particular, they are concerned about the influence of previous alcohol abuse even if the patients remained abstinent for 6 or even more months. The patients included in our study presented a rather wide variety of etiologies; the majority (23 of 40) presented with postviral cirrhosis. As opposed to the patients observed by Pozzi and coworkers (2), a mixed etiology, postviral and postalcoholic, was present in only one case in our series. To further explore the possible effect of previous alcohol abuse, we re-examined our data by comparing the E/A ratio, an index of diastolic function of the left ventricle, in eight pure postalcoholic (1.15 0.27) and 22 postviral (1.09 0.2) patients. No difference was seen (t test, p = 0.27) between 6 month abstinent postalcoholic cirrhotics and those of post viral etiology.