1076 Prevalence of Cirrhotic Cardiomyopathy and Its Correlation With Serum Pro-BNP Levels, HRS, SBP, and Mortality

Abstract

INTRODUCTION: Cardiac dysfunction is common in patients with cirrhosis. This study aims at estimating the Prevalence of Cirrhotic Cardiomyopathy and its correlation with pro-BNP levels, Hepatorenal Syndrome (HRS), SBP (Spontaneous bacterial peritonitis) And Mortality. METHODS: This was a prospective study in which we used newer technique Doppler Echocardiography and also did conventional 2D and Doppler echocardiography in cirrhotic patients. Additionally, QTc interval, pro-BNP, Tropinin T levels were measured. Patients were followed up for 6 month to look for any new complications that developed like hepato-renal syndrome, Spontaneous bacterial peritonitis or any mortality. RESULTS: In our study 53 cirrhotic patients were compared with 30 controls whose age and sex was matched. The results in 53 cirrhotic patients: mean age 43.81 ± 12.31yr, M:F: 49:4)etiology:alcoholic-27,nonalcoholic-26,child score(A-0,B-15,C-38),MELD Score was 18.17 ± 1.69 in diastolic dysfunction group and 16.36 ± 1.70 in cirrhotic patients without diastolic dysfunction. Doppler Echocardiography showed mean early diastolic velocity of 11.6 ± 2.6 vs 19.8 ± 6 cm/sec(P < 0.01) and mean late diastolic velocity of 10.7 ± 2.9 vs 8.4 ± 3.1 cm/sec(P < .05).The mean Doppler E- velocity was 0.76 ± .16 vs 0.88 ± 0.14 (P < 0.05),A-velocity was 0.72 ± 0.25 vs 0.53 ± 0.11(P < 0.01), DT was 231 ± 49.60 vs 212.9 ± 61.9 (p-NS) and E/A ratio was 1.14 ± 0.34 vs 1.7 ± 0.43(P < 0.01). The troponin-T levels were <.01ng/ml(normal range).The mean pro-BNP level was 447.62 ± 225.72 pg/ml (normal for our lab < 125 pg/ml).Mean QTc interval was 509.37 ± 54.32 msec. CONCLUSION: The study showed that diastolic dysfunction is highly prevalent (56.6% of study population) in cirrhosis. QTc interval and BNP were also significantly raised. In addition Cirrhosis complications like Hepatorenal Syndrome (HRS), SBP (Spontaneous bacterial peritonitis), and Hepatic Encephalopathy were more common in cirrhotic cardiomyopathy group.