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Journal of Cardiovascular Medicine and Surgery

Volume  5, Issue 2, Apr-June 2019, Pages 53-56
 

Original Article

Evaluation of Functional and Structural Cardiac Status of Adult Patients with Cirrhosis of Liver

Archit Dahiya, Parvati Nandy, Isha Nandal,

1 Senior Resident, Department of Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences or PGIMS, Rohtak, Haryana 124001, India. 2 Professor, Department of Medicine, Sikkim Manipal Institute of Medical Sciences (SMIMS), Gangtok, Sikkim 737102, India. 3 PG Trainee, SGT Medical College, Gurugram, Haryana 122505, India.

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.5219.1

Abstract

Introduction: Cardiac abnormalities in patients with cirrhosis includes a combination of reduced cardiac contractility with systolic and diastolic dysfunction and electrophysiological abnormalities. This study will aim to evaluate the structural and functional abnormalities of cardiac function in patients with cirrhosis of liver, correlate such abnormalities with the severity of the cirrhosis such that, in future the cardiac aspects of cirrhosis of liver can also be catered to, during the patient's treatment. Methods: This hospital based observational study was conducted for a period of one year and included 100 cases of cirrhosis of liver. A 12-lead ECG and 2D ECHO was performed in all patients. The left ventricular mass was calculated using the formula known as the 'ASE- cube formula'. Patients were classified under MELD criteria. Results: In our study, 68% patients were having MELD score between 19-24. There was significant statistical correlation of MELD with QTc, LVEDD, LV mass and E/A ratio. This study showed that QTc prolongation is a frequent finding in patients with liver disease. The LVEF was normal (≥ 55%) in all patients of the study group. The left atrial diameter and left ventricular end diastolic diameter was above normal limits in 100% and 17% of patients of the study group respectively. LV mass was more than the normal in 49% of the patients. The E/A ratio was ≤ 1.0 in 94% of the patients. Conclusion: Clinicians need to be aware of the occurrence of cardiac dysfunction in long standing patients of cirrhosis of liver, especially those who are decompensated with complications like ascites. Cardiac evaluation with non-invasive investigations like ECG and echocardiography should be included in the diagnostic algorithm of such patients to simultaneously identify cardiac compromise and to tailor therapy of such patients so as not to further worsen the cardiac overload and diastolic dysfunction.

 


Keywords : Cirrhosis; ECHO; ECG.
Corresponding Author : Archit Dahiya