A study to assess the echocardiographic changes among chronic liver disease in a tertiary care center


  • Aradya H. Venu Department of Gastroenterology, JSS Medical College, Mysore, Karnataka, India
  • Col Muralidhar Department of General Medicine, Command Hospital, Air Force, Bangalore, Karnataka, India




Cardiac, Child, Cirrhosis, Echocardiography, Liver disease


Background: Cirrhosis is associated with numerous cardiac abnormalities; however scanty information is available about the changes associated with it in Indian diaspora. which include increased cardiac output, left ventricular diastolic dysfunction, increased wall thickness of cardiac chambers, and pulmonary arterial hypertension. These concomitant cardiac abnormalities in patients with cirrhosis have been termed as ‘Cirrhotic Cardiomyopathy’. Objective of this study assess the Echocardiographic Changes among Chronic Liver disease in a tertiary care center. Method: Thirty patients with cirrhosis (alcoholic and non-alcoholic) were enrolled for the study at Department of Gastroenterology, Command Hospital, Air force, Bangalore from October 2007 to June 2009. Thirty age and sex matched controls without cardiovascular disease were included for comparison. Data collection was done by clinical history, examination and investigations. All subjects underwent Echocardiographic study was at 6 and 12 months and controls at the start of study.

Results: Mean age of the study population was 54.5±15 yrs, males constituted 93% of the study population. Majority of the patients were in Child class B (43.3%) and Child A (40%). Interventricular septal thickness showed significant change compared to Control. There was no evidence of systolic dysfunction noted in the study population. There was no correlation between severity of cirrhosis and echocardiographic Changes.

Conclusion: This study demonstrates that Indian patients with cirrhosis do have diastolic dysfunction. In the absence of other risk factors for cardiac disease, this dysfunction can be attributed only to cirrhotic cardiomyopathy. There is no correlation of cardiac status with severity of liver dysfunction.


Gould L, Shariff M, Zahir M, Di Lieto M. Cardiac hemodynamics in alcoholic patients with chronic liver disease and a presystolic gallop. J Clin Invest 1969;48(5):860-8.

Kowalski HJ, Abelmann WH. The cardiac output at rest in Laennec’s cirrhosis. J Clin Invest. 1953; 32(10):1025-33.

Regan TJ, Levinson GE, Oldewurtel HA, Frank MJ, Weisse AB, Moschos CB. Ventricular function in noncardiacs with alcoholic fatty liver: role of ethanol in the production of cardiomyopathy. J Clin Invest. 1969;48(2):397-407.

Caramelo C, Fernandez‐Muñoz D, Santos JC, Blanchart A, Rodriguez‐Puyol D, López‐Novoa JM, et al. Effect of volume expansion on hemodynamics, capillary permeability and renal function in conscious, cirrhotic rats. Hepatol. 1986;6(1):129-34.

Lee SS. Cardiac abnormalities in liver cirrhosis. West J Med. 1989;151(5):530-5.

Navasa M, Feu F, García‐Pagan JC, Jiménez W, Llach J, Rimola A, et al. Hemodynamic and humoral changes after liver transplantation in patients with cirrhosis. Hepatol. 1993;17(3):355-60.

Ruiz‐del‐Arbol L, Monescillo A, Arocena C, Valer P, Gines P, Moreira V, et al. Circulatory function and hepatorenal syndrome in cirrhosis. Hepatol. 2005;42(2):439-47.

Blendis L, Wong F. Is there a cirrhotic cardiomyopathy? Am. J. Gastroenterol. 2000; 95: 3026-8.

Ma Z, Lee SS. Cirrhotic cardiomyopathy: getting to the heart of the matter. Hepatol. 1996,24(2):451-9.

Jaue DN, Ma Z, Lee SS. Cardiac muscarinic receptor function in rats with cirrhotic cardiomyopathy. Hepatol. 1997,25(6):1361-5.

Valeriano V, Funaro S, Lionetti R Et al. Modification of cardiac function in cirrhotic patients with and without ascites. Am. J. Gastroenterol. 2000;95(11):3200-5.

Galderisi M, Dini FL, Temporelli PL, Colonna P, de Simone G. Doppler echocardiography for the assessment of left ventricular diastolic function: methodology, clinical and prognostic value. Ital. Heart J. 2004;5:86-97.

Pozzi M, Carugo S, Boari G, Pecci V, De Ceglia S, Maggiolini S, et al. Evidence of functional and structural cardiac abnormalities in cirrhotic patients with and without ascites. Hepatol. 1997 Nov;26(5):1131-7.

Soyoral Y, Ali Süner, Kıdır V, Arıtürk Z, Balakan O, Halil. The effects of viral cirrhosis on cardiac ventricular function. European Journal of General Medicine. 2004;1(2):15-8.

Gaskari SA, Liu H, Moezi L, Li Y, Baik SK, Lee SS. Role of endocannabinoids in the pathogenesis of cirrhotic cardiomyopathy in bile duct-ligated rats. Br J Pharmacol. 2005;146(3):315-23.






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