A Clinical Study of Cardiovascular Dysfunction in Patients of Cirrhosis of Liver.

ABSTRACT

Background: Cirrhosis is a very common ailment in India mostly caused by alcoholism, viral hepatitis and malnutrition. The clinical picture of patients with cirrhosis is dominated by the classical complications such as ascites, bleeding from esophageal varices, portal hypertension and encephalopathy. Cardiovascular abnormalities have been reported by several investigators. Methods: It is a cross sectional study done on 60 patients admitted to NIMS Medical College, Jaipur between Jan. 2013 to Dec. 2014. USG of liver was done by GE Voluson promachine with probe frequency of 3.5 MHz and high frequency of 7-10 MHz for detection of cirrhosis and ascites with special reference to caudate lobe, portal vein and spleen. ANOVA with post hocTukey HSD was used for analysis of continuous variables whereas Chi-square test was used for nominal/ categorical variables. p value < 0.05 was taken as significant. Results: Diastolic dysfunction is measured by E/A ratio was prevalent LVED diameter, IV septal thickness, left ventricular posterior wall thickness were proportional to severity of liver cirrhosis. Electro physiologically, 38.33% patients of cirrhotic liver patients had prolonged QTc interval. Here, as far as cardiac abnormality were considered, we found QTc prolongation more in severe degree of cirrhosis MELD score III (7 out of 10) 70%, than moderate (40%) MELD score II and mild (20%) MELD score I of cardiac QTc prolongation. Conclusion: Diastolic dysfunction is a major criteria of cirrhotic cardiomyopathy which can be diagnosed by electro and echo cardiography