Abstract
Background and Aim: The association between cirrhotic cardiomyopathy (CCM) and adrenal insufficiency (AI) is still not well declared. We aimed to study the association between CCM related echocardiographic (ECHO) parameters and AI in patients with advanced liver cirrhosis. Patients and Methods: A cross sectional study was carried out on 60 adult patients with advanced liver cirrhosis (Child’s C) who showed a low ejection fraction (EF) of Results: The mean age was 63.83±7.64 with male sex predominance (87.4%). Their mean EF was 39.17±7.34, while 88.4% of them had a high LVEDD with a mean of 62.31±10.21 mm. The mean morning fasting free serum cortisol level was 7.95±5.23 mcg/dl with 48.4% of them having AI. Comparison of those with and without AI showed that the former group had a higher LAD (43.26±10.04 vs 42.76±7.64), LVESD (50.83±10.66 vs. 48.08±8 .17) and LVEDD (64.83±9.95vs. 59.94±9.97)) respectively. However, the difference was not statistically significant (P>0.05). There was no significant correlation between any of the CCM parameters or those of hepatic decompensation and the fasting serum cortisol level among the studied group (P>0.05). Conclusion: There was no significant correlation between AI and any of the selected parameters related to CCM.
Highlights
Liver cirrhosis is a major health problem in Egypt that is mostly related to the high prevalence of hepatitis C virus infection (HCV)
The study was carried out on 60 patients diagnosed as advanced (Child C) liver cirrhosis according to definition [4] who showed a low ejection fraction (EF)
It was shown that their mean ejection fraction (EF) was 39.17mm±7.34, with 88.4% of them having abnormally increased left ventricular end diastolic diameter (LVEDD) 88.7% end systolic left ventricular diameter (LVESD) while only 44.2% had abnormally increased left atrial diameter (LAD) according to definitions [6] (Table 2)
Summary
Liver cirrhosis is a major health problem in Egypt that is mostly related to the high prevalence of hepatitis C virus infection (HCV). Its prevalence was estimated to be 11.9% among the general population [1]. It is a major cause of mortality worldwide [2] that progresses at variable rates depending on the cause of liver disease, host and environmental factors [3]. Cirrhotic cardiomyopathy (CCM) is defined as a suboptimal ventricular contractile response to stress in the absence of cardiac disease [5]. The association between cirrhotic cardiomyopathy (CCM) and adrenal insufficiency (AI) is still not well declared. We aimed to study the association between CCM related echocardiographic (ECHO) parameters and AI in patients with advanced liver cirrhosis
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