Should We Confine the Cardio Hepatic Syndrome Only in Congestive Cardiac Failure Patients?

Abstract

AbstractIntroduction: Liver function abnormalities are not uncommon in patients with heart failure. Multiple reasons have been cited like impaired perfusion or elevated right-sided cardiac pressures, or are secondary to drug toxicity. In this study, we analyzed the patients admitted at our center to detect the profile of cardio-hepatic syndrome. This analysis may explore new etiologies for cardio-hepatic syndrome.Materials And Methods: This is an observational retrospective study done at our institute. We collected the liver function tests which were conducted in patients admitted in cardiology in 2015 (Jan to Dec at our center. Patients having abnormal liver function tests were analyzed for various etiologies. SGPT value > 45 Units per liter is considered as elevated.Results: Out of the patients admitted to cardiology department, SGPT and SGOT values are available in 2803 and 4577 patients respectively. Mean age of these patients was 58±12.9 yrs.In SGPT group 1881 were males. In 432(15.4%) patients SGPT was elevated. In them 326 (76%) were males. Among the patients in whom SGPT is elevated, also had elevated CPK and CPK-MB due to MI were in 154 patients (35.6%). In 24 patients (5.6%) SGPT was elevated along with NT pro BNP levels. Rest of the SGPT elevated patients (254 – 58.8%) does not come under CCF or MI category and out these patients about 146 patients were on either on statin or other drugs which can increase the liver enzymes. Still we require to evaluate the cause of hepatic abnormality in 106(24.5%) patients admitted with cardiac disease.Conclusions: Cardio-hepatic syndrome is not just confined to heart failure. Though heart failure, MI and drug induced hepatic dysfunction accounted for 75.5% of the etiology, we require to see present unknown the etiology for this sub group of cardio hepatic syndrome. Further elucidating the etiology for the remaining 24.5% cardio hepatic syndrome is of much interest.