Abstract
Background and Aims: Patients with advanced liver cirrhosis may develop cirrhotic cardiomyopathy, which is defined as a chronic cardiac dysfunction in patients with cirrhosis, characterized by blunted contractile responsiveness to stress, and/or altered diastolic relaxation with electrophysiological abnormalities, in the absence of known cardiac disease. This study was done to assess and compare the cardiac functional status of alcoholic and non-alcoholic cirrhosis patients and controls. Methods: This was a cross-sectional descriptive study evaluating the cardiac functional status of 100 liver cirrhosis patients (40 patients of alcoholic cirrhosis and 60 patients of non-alcoholic cirrhosis), admitted in gastroenterology Department of SMS Medical College, from Jan 2017 to Jan 2018. Age and sex matched forty healthy subjects without any history of cardiac and liver disease was selected as a controls. Selected individuals were subjected to clinical evaluation including history, physical examination, haematological, biochemical, ECG, 2D-ECHO and endoscopic studies. Results: EF of cirrhotic patients was significantly high compared to controls. The mean PASP among the cirrhotics and controls were 28.2 + 9.06 and 20.4 + 4.21 mmHg respectively and the difference was statistically significant. Forty-eight cirrhotic patients (48%) had diastolic dysfunction compared to 10 (25%) in the control group which was significant. QTc interval was significantly higher in cirrhotics (0.44) compared to controls (0.40) and in alcoholic cirrhosis (0.46) compared to non-alcoholic cirrhosis (0.43) patients. Conclusions: Assesing cardiovascular involvement in a cirrhotic patient is important in planning treatment and assessing prognosis. This study has brought out a pattern of cardiac involvement in cirrhosis. The authors have none to declare. Table 1Tabled 1ParameterType of casesRangeMean ± SDP valueLVIDs (cm)Cirrhosis cases2.51–4.353.19 ± 0.48NSControls2.91–3.413.14 ± 0.15LVIDd (cm)Cirrhosis cases3.59–5.74.79 ± 0.5NSControls4.13–5.224.71 ± 0.35EF (%)Cirrhosis cases50–8668.56 ± 6.79<0.001SControls60–7163.13 ± 3.70IVSd (cm)Cirrhosis cases0.45–1.40.86 ± 0.19NSControls0.67–1.040.89 ± 0.09LVPWd (cm)Cirrhosis cases0.5–1.90.88 ± 0.25NSControls0.6–1.150.85 ± 0.15 Open table in a new tab Table 2Tabled 1Pattern of diastolic dysfunctionControls (n = 40)Total Cirrhosis (n = 100)Alcoholic cirrhosis (n = 40)Non-alcoholic cirrhosis (n = 60)Impaired relaxation pattern6 (15%)28 (28%)13 (32.5%)15 (25%)Pseudo normal pattern2 (5%)11 (11%)4 (10%)7 (11.6%)Restrictive pattern2 (5%)9 (9%)2 (5%)7 (11.6%)Total10 (25%)48 (48%)19 (47.5%)29 (48.2%)P Value<0.05 (S)*<0.05 (S)*<0.05 (S)*NS** Open table in a new tab
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