Study of cardiac manifestations in patients with chronic liver disease
DOI:
https://doi.org/10.18203/2349-3933.ijam20195233Keywords:
Chronic liver disease, Diastolic dysfunction, Pro-BNP, QT prolongationAbstract
Background: Chronic liver disease is a common cause of mortality and morbidity worldwide. This has pathological effects on various systems in the body including cardiovascular system which usually is unnoticed. In majority of cases of chronic liver disease, cardiovascular complications develop as a subclinical condition which manifests only during stressful situations. Hence early detection of cirrhotic cardiomyopathy by echocardiography and 2D-ECHO studies in all patients of chronic liver disease helps in reducing the morbidity and mortality.
Methods: 100 cases of chronic liver disease were included in the study. Data was collected through a prepared proforma. All patients were subjected to cardiac evaluation by ECG and Echocardiography. Serum pro-BNP levels were done for selected patients. Severity of the liver disease was assessed by using Child-Pugh score. Cardiac abnormalities were noted and correlated with the severity of the liver disease.
Results: Out of 100 patients studied, 83% were males. 80% of the patients had history of alcoholism. 59% of the patients had abnormal ECG finding. 40% of them had QT prolongation and was related to the severity of liver disease. 60% of the total patients studied had positive pro-BNP values in patients with significant cardiac dysfunction. 46% of the patients had normal echocardiographic finding; most common abnormal finding was diastolic dysfunction (43%) and positively correlated with severity of liver disease.
Conclusions: In chronic liver disease patient’s QT prolongation is the most common ECG abnormality. Most common Echocardiographic finding was diastolic dysfunction which had strong correlation with the severity of the liver disease.
Metrics
References
Zaky A, Lang JD. Cirrhosis-associated cardiomyopathy. J Anesth Clin Res. 2012;3(266):2.
Scott L. Friedman. Hepatic fibrosis. In: Schiff ER, Maddrey WC, Sorrell MF eds. Schiff”s The diseases of the liver, 11th Ed, USA, Lippincott Williams and Wilkins; 2012:297-311.
Garcia-Tsao G, Lim J. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. The Am J Gastroent. 2009;104(7):1802-29.
Fede G, Privitera G, Tomaselli T, Spadaro L, Purrello F. Cardiovascular dysfunction in patients with liver cirrhosis. Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterol. 2015 Jan;28(1):31.
Timoh T, Protano MA, Wagman G, Bloom M, Vittorio TJ. A perspective on cirrhotic cardiomyopathy. In Transplantation proceedings. Elsevier. 2011 Jun 1;43(5);1649-53.
Ruiz-del-Arbol L, Serradilla R. Cirrhotic cardiomyopathy. World J Gastroenterol. 2015;21(41):11502-21.
Bernardi M, Rubboli A, Trevisani F, Cancellieri C, Ligabue A, Baraldini M, et al. Reduced cardiovascular responsiveness to exercise-induced sympathoadrenergic stimulation in patients with cirrhosis. J Hepatol. 1991;12(2):207-16.
Wong F, Girgrah N, Graba J, Allidina Y, Liu P, Blendis L. The cardiac response to exercise in cirrhosis. Gut. 2001;49(2):268-75.
Valeriano V, Funaro S, Lionetti R, Riggio O, Pulcinelli G, Fiore P, et al. Modification of cardiac function in cirrhotic patients with and without ascites. The Am J Gastroen. 2000;95(11):3200.
Finucci G, Desideri A, Sacerdoti D, Bolognesi M, Merkel C, Angeli P, et al. Left ventricular diastolic function in liver cirrhosis. Scandinavian J Gastroent. 1996;31(3):279-84.
Zambruni A, Trevisani F, Caraceni P, Bernardi M. Cardiac electrophysiological abnormalities in patients with cirrhosis. J Hepatol. 2006;44(5):994-1002.
Chayanupatkul M, Liangpunsakul S. Cirrhotic cardiomyopathy: review of pathophysiology and treatment. Hepatol intern. 2014;8(3):308-15.
Zardi EM, Abbate A, Zardi DM, Dobrina A, Margiotta D, Van Tassell BW, et al. Cirrhotic Cardiomyopathy J Am Coll Cardiol. 2010;56(7):539-49.
Liu H, Gaskari SA, Lee SS. Cardiac and vascular changes in cirrhosis: pathogenic mechanisms. World J Gastroentero: WJG. 2006;12(6):837.
Wong F, Logan A, Blendis L. Systemic hemodynamic, forearm vascular, renal, and humoral responses to sustained cardiopulmonary baroreceptor deactivation in well‐compensated cirrhosis. Hepatology. 1995 Mar;21(3):717-24.
Downloads
Published
How to Cite
Issue
Section
