A STUDY OF CARDIAC DYSFUNCTION AND CONDUCTION DISTURBANCES IN NON ALCOHOLIC CIRRHOTIC PATIENTS
Journal Title: IJSR-International Journal Of Scientific Research - Year 2017, Vol 6, Issue 9
Abstract
Liver Cirrhosis is associated with wide range of cardiac abnormalities in the form of structural and hemodynamic alterations. These changes are reported mainly in alcoholic patients and are collectively termed as Cirrhotic cardiomyopathy. Cirrhotic cardiomyopathy can manifest with an increased cardiac output, systolic and diastolic dysfunction and electrophysiological abnormalities. AIMS : This study is aimed to evaluate the cardiac dysfunction and conduction disturbances in non alcoholic cirrhotic patients and to assess their relationship with the severity of cirrhosis and ascites. Methods: This is a retrospective study study of 30 patients done at The Department of Digestive Health and Diseases, Government Peripheral Hospital, Anna Nagar, Chennai. All patients with non alcoholic cirrhosis of liver were subjected to electrocardiography and echocardiography. The results were interpreted and analyzed for their association with severity of cirrhosis. Results: Out of the total 30 cases, cirrhosis due to hepatic B and Hepatitis C viral infections were 12 and 1case respectively. 1case of primary biliary cirrhosis, 10 were due to non-alcoholic fatty liver disease and in 6 patients the cause was Not known. Of the 30 patients included in the study, 20 cases (66.67%) had Class A CTP and 10 cases (33.3%) had Class B CTP. Echocardiography study showed, 14 patients had end diastolic volume above 90 and 3 patients had end systolic volume above 38. Around 26 patients showed features of cirrhotic cardiomyopathy, of which 16 patients had CTP Class A and 10 patients had CTP Class B. 4 patients with CTP Class A did not have cirrhotic cardiomyopathy at all. Electrocardiogram study showed a QTc prolongation in 16 patients (53.3%). Conclusion: Non alcoholic Cirrhotic patients also have evidence of cirrhotic cardiomyopathy in the form of diastolic dysfunction and prolonged QTc interval. The severity of cirrhosis does not correlate with the presence of diastolic dysfunction. Prolongation of QTc interval is influenced by the sex of the cirrhotic individuals. Ventricular end diastolic volume, end systolic volume and ejection fraction are not significantly affected in cirrhotic individuals. Cirrhotic cardiomyopathy in these patients is independent of the etiology of cirrhosis and Ascites is a significant feature of all cases with diastolic dysfunction.
Authors and Affiliations
Ratnakar Kini, Babukumar Shanmugam
Keywords
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