Cardiac dysfunction in cirrhosis is not associated with the severity of liver disease (original) (raw)
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Cardiac dysfunction in liver cirrhosis: A tissue Doppler imaging study from Egypt
PubMed, 2015
Background: Patients with liver cirrhosis suffer from various cardiac abnormalities, which may influence their outcome. Tissue Doppler recording of the mitral and tricuspid annular diastolic velocities can be used to assess diastolic function accurately. There has been very little published information regarding RV diastolic function in liver cirrhosis. This study is aimed at evaluating right and left ventricular systolic and diastolic functions in post hepatitis C liver cirrhosis patients using conventional echocardiography and tissue Doppler imaging. Methods: This study was conducted on 75 adults from inpatient and outpatient services of the Theodor Bilharz Research Institute (TBRI) hospital. They were divided into two groups: Group 1 included 50 patients with post hepatitis C liver cirrhosis; and Group 2 included 25 normal adults serving as a control group. All patients and normal volunteers were subjected to clinical examination, laboratory evaluation, abdominal ultrasonography and echocardiographic studies with tissue Doppler imaging for evaluation of left and right ventricular systolic and diastolic functions. Results: The mitral flow showed significant increase in A wave velocity, as well as DT and IVRT with a significant decrease in E/A ratio in Group 1 compared to Group 2 (P<0.01). The tricuspid flow also showed a significant increase in A wave velocity (P<0.01) and DT (P<0.05) in addition to a significant decrease in E wave velocity and E/A ratio (P<0.01) in Group 1 as compared to Group 2. At the mitral annulus, we found a significant increase in average Aa velocity, E/Ea ratio and average systolic wave velocity S, in addition to a statistically significant decrease in the average Ea velocity and average Ea/Aa (P<0.01) in Group 1 as compared to Group 2. At the tricuspid annulus, there were significant increases in the average Aa velocity (P<0.01), S velocity (P<0.01) and E/Ea (P<0.05) together with a statistically significant decrease in the average Ea/Aa and average Ea velocity (P<0.01) in Group 1 compared to Group 2. Conclusion: It is important to evaluate the cardiovascular function in every patient with cirrhosis, especially if the patient is a candidate for any intervention that may affect haemodynamics.
National Journal of Medical Research, 2014
Introduction: Cirrhosis is a pathologically defined as an entity associated with a spectrum of characteristic clinical manifestations like irreversible chronic injury of the hepatic parenchyma and include extensive fibrosis in association with the formation of regenerative nodules. Cardiac dysfunction in cirrhosis, a problem on the ‘blind side of the heart’, often remains ignored. Methodology: This was ahospital based cross-sectional study, carried out under the department of medicine, SMIMER, Surat. All patients were informed about the study and their verbal consent was obtained. Patients fulfilling the inclusion criteria (n=50) were taken into study and all patients were studied for the clinical profile, laboratory investigation, imaging study like chest X-ray & Ultrasonography abdomen and 2D echocardiography. All patients were hospitalized and blood pressure and heart rate were measured. Result: History of alcohol consumption was found in 36(72%) of the patients. Most common symptoms were ascitis, jaundice and malena. Mean total count was 7144(±1568). Mean blood urea level was 38.4(±19.78) while mean serum creatinin was 1.0(±0.72). Mean albumin level was 2.9 (±0.81). Mean serum billirubin total, direct and indirect was 6.1(±8.08), 4.35(±5.98), 1.8(±2.19) respectively. Diastolic dysfunction was present in about 66% (33 out of 50) of patients. Conclusion: The patients of cirrhosis develop cirrhotic cardiomyopathy and this cirrhotic cardiomyopathy was not related to the etiology of liver cirrhosis.
A Study of Echocardiographic Changes in Patients with Cirrhosis of Liver
International Journal of Advanced Research, 2021
Background/Aims: Cirrhosis is associated with a significant number of cardiac abnormalities but, the information available is scanty about the changes associated with it in India. Which include increased cardiac output, increased wall thickness of cardiac chambers, left ventricular diastolic dysfunction, and PAH. These cardiac abnormalities in patients with Cirrhosis have been termed as Cirrhotic Cardiomyopathy. Cirrhotic Cardiomyopathy may be a significant cause of morbidity and mortality in patients with Cirrhosis. With the advent of increased liver transplantation in India, this entity may have an impact on transplantation success. The present study aims to evaluate the cardiac abnormalities in patients with cirrhosis using 2D Echocardiography to detect the occurrence of LV dysfunction, pulmonary hypertension, pericardial effusion, and to assess the contribution of cardiac dysfunction on mortality, if any. Methodology: Thirty patients with Cirrhosis (alcoholic and non-alcoholic) ...
Study of Cardiac Abnormalities in Patient with Cirrhosis of Liver
Scholars Journal of Applied Medical Sciences, 2020
Original Research Article Background: Cirrhosis is defined as diffuse disruption of the normal architecture of the liver with fibrosis and nodule formation. There are significant secondary effect of cirrhosis on cardiac, pulmonary and renal systems. Cirrhotic cardiomyopathy includes combination of reduced cardiac contractility with systolic and diastolic dysfunction and electrophysiological abnormalities. Objectives: To analyze the cardiac abnormalities in cirrhotic patients. Materials and methods: This is a retrospective study conducted at Department of General Medicine, MIMS, Mandya. ECG and 2D ECHO reports of patients admitted with cirrhosis of liver were obtained from case sheets, data entered into Excel sheet and analysed. Results: Out of the hundred patients included in study, 43 Patients had diastolic dysfunction, 19 patients had systolic dysfunction on echocardiography. 26 patients had dilated cardiomyopathy, 4 patients had mitral regurgitation, 5 patients had atrial fibrillation, 3 patients had RV dysfunction with pulmonary hypertension, ECG in 40 patients showed QTc prolongation. Conclusion: In our study Diastolic dysfunction was the most common cardiac abnormality found on echocardiography. Apart from conventional complications of cirrhosis, cardiac abnormalities are frequently present in patients with cirrhosis of liver. Which will adversely affect morbidity and mortality in these patients.
Echo Study in Patients with Cirrhosis of Liver
National Journal of Medical Research, 2014
Objective: The objective of this study was to evaluate cardiac function with echocardiography in liver cirrhosis. Methods: With purposive sampling 75 cases and 25 controls were taken in these studies who hadpresence of signs of free fluid on physical examination, and presence of signs of cirrhosis on USG abdomen in a tertiary care hospital during June 2006 to August 2007. All 100 patients were studied for the clinical profile, laboratory investigation, imaging study and 2D echocardiography. Results: Mean pulse rate of the study group is 99/min where as 72.8/min for the control group. Mean blood pressure of the study group is 90.42mmHg where as 109.81mmHg for the control group. There is significantly higher QTc interval in cirrhosis cases as compared to control. The echocardiography results obtained in this study show significantly higher right & left atrial diameter in cirrhotic patients as compared to the control group. Conclusion: In our study, no significantly difference is noted for ME, MA, ME/MA,DTC(mitral) between case and control group.(P>0.05)
Cardiac dysfunction in cirrhosis
Hepatology Research, 2003
In cirrhosis, cardiac symptoms and physical signs occur as the liver functions worsen. Cirrhosis is associated with hyperdynamic circulation and b-adrenergic system activation responsible for the cardiovascular changes. The purpose of the present study was to explore the cardiovascular response to exercise in cirrhotic patients. A total of 20 patients (16 men, four women) with cirrhosis of hepatitis B or C without any cardiac dysfunction were included in the study. Ten people (eight men, two women) were enrolled in the control group. Plasma noradrenaline and adrenaline concentrations, blood pressures in supine and standing positions, exercise echocardiography and exercise radionuclide ventriculography were carried out. In cirrhotics, the exercise capacity was lower and also there was an impaired cardiovascular response to exercise with lower than expected peak heart rate without any cardiac dysfunction, which may have important clinical implications for the ability of these patients to withstand cardiovascular stress.
Vojnosanitetski pregled, 2016
Background/Aim. Cirrhotic cardiomyopathy (CCM) is a clinical syndrome in liver cirrhosis (LC) patients, which is characterized by the abnormal cardiovascular (CV) response to physiologic, pathologic, or pharmacologic stress provocation, but normal to increased cardiac output and contractility at rest. The aim of the study was to identify the structural and functional myocardial changes in patients with LC of various origins in advanced stages of the disease, by transthoracic two-dimensional echocardiography Doppler imaging evaluation in the prediction of CCM. Methods. The research was performed as a prospective, nest case-control study, on carefully selected 40 patients in the advanced stage of LC and negative personal medical history on previous CV disease and 40 healthy subjects as the control, from January 2012?December 2014. There were determining significant echocardiographic parameters in LC patients as predictors for the development and/or presence of CCM. Results. Most of th...
Factors Predicting Cardiac Dysfunction in Patients with Liver Cirrhosis
Middle East Journal of Digestive Diseases
BACKGROUND Left ventricular diastolic dysfunction (LVDD) is the earliest cardiac dysfunction noted in patients with liver cirrhosis, which increases the morbidity and mortality in such patients. There are sparse studies from India evaluating the predictive factors of LVDD in patients with cirrhosis. Hence we undertook this prospective study with an aim to evaluate the factors predicting the development of LVDD in liver cirrhosis. METHODS 104 patients with cirrhosis were enrolled in this prospective study. A detailed cardiac evaluation was done by 2 D echocardiography with tissue Doppler imaging by an experienced senior cardiologist. The severity of liver disease was defined by Model For End-Stage Liver Disease (MELD) and Child-Pugh score. RESULTS The prevalence of LVDD was 46% in our study. Multivariate logistic regression analysis revealed that serum albumin, MELD score, and presence of ascites (OR = 0.1, 95%CI 0.03-0.3, p < 0.001; Or = 1.12, 95%CI 1.03-1.22, p < 0.001; OR = ...
Cardiovascular dysfunction in patients of cirrhosis of liver
International Journal of Advances in Medicine
Background: Cirrhosis of liver refers to a progressive condition that disrupts the normal architecture of the liver. It is increasingly recognized that cirrhosis per se can cause cardiac dysfunction. The aim was to assess cardiovascular dysfunction electrocardiographically and echocardiographically in patients with cirrhosis of liver and to find the correlation between cardiovascular dysfunction and severity of liver cirrhosis as per child-PUGH score.Methods: Total 90 patients of cirrhosis of liver of both sexes were included in this cross-sectional study conducted from January 2018 to August 2019 in SGRDIMSR, Sri Amritsar. The severity of liver cirrhosis was assessed as per Child Pugh Score. QTc interval was calculated by Bazett’s formula. Systolic and Diastolic dysfunction was seen on 2D-echocardiography.Results: QTc interval increased linearly with the severity of liver cirrhosis. Mean values of QTc in Child Pugh Class A=425.00(±20.97), Class B=437.35(±42.60), Class C=479.71(±29....