Early Detection of Cirrhotic Cardiomyopathy Using Cardiac Bio-Markers: A Cross Sectional Study
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 10
Abstract
Introduction: Cirrhosis is well known to be associated with severe hemodynamic changes like hyperdynamic circulation, increased cardiac output, increased heart rate and decreased systemic vascular resistance resulting in cirrhotic cardiomyopathy (CCM). Patient with CCM are at higher risk for complications during surgeries and liver transplantation. Hence early detection may be beneficial in offering treatment even in patients asymptomatic for heart disease. Objectives: To determine the presence of elevated cardiac biomarkers in patients with chronic liver disease and to study the relationship between these cardiac biomarkers and severity of chronic liver disease. Methods: Cross sectional study including 50 adult patients diagnosed with chronic liver disease. Patients were subjected to detailed history and physical examination, basic biochemical profile, and cardiac biomarkers (Troponin I, CK MB, BNP). Severity of liver disease was assessed using Child-Pugh and MELD scores. The levels of cardiac markers in the study population, and their correlation with disease severity were evaluated using appropriate statistical methods. Results: In the present study of 50 patients with chronic liver disease (CLD) the mean age was 46.48 years and 84%were male. 68% had alcohol related CLD, and 4% had chronic Hepatitis B. Troponin I was elevated in 12(24%) patients, CKMB in 46(92%) and BNP in 20(40%) patients. The elevation in cardiac enzymes demonstrated a linear correlation with severity of liver disease, Troponin I correlated significantly with Child Pugh score (p= 0.001) and Meld score(p=0.015); BNP with Child Pugh score(p=0.001) and MELD score(p=0.022). There was no statistically significant relationship between CKMB and severity of liver disease. Conclusion: Troponin I may prove to be an useful marker of myocardial injury in chronic liver disease patients and elevated BNP may reflect an underlying cardiac dysfunction. Use of these biomarkers for screening patients with advanced liver disease may aid in early detection of cirrhotic cardiomyopathy
Authors and Affiliations
Dr D. Udayashankar MD
Keywords
Related Articles
- EP ID EP529616
- DOI -
- Views 85
- Downloads 0
Clinical Profile and Management of Lower G.I. Malignancies
Introduction: Lower GI malignancies though more common in the western part of world and are increasing in our country for the past decade. Colorectal cancer is the most common malignancy in the gastrointestinal tract. In...
Antimicrobial Assessment of Fresh Ripe and Dry Ripe Musa sapientum L. Peels against Selected Isolates Associated with Urinary Tract Infection in Port Harcourt, Nigeria
Banana peels is the outer coverage of the banana fruits commonly used to feed animals, fish and many others or thrown away as waste. Almost every part of a banana plant has medicinal values. Urinary Tract Infection is an...
A Study of Acute Kidney Injury in the Pregnant Patient –Our experience at Rural centre
Pregnancy-related acute kidney injury (PR-AKI) causes significant maternal and fetal morbidity and mortality. Management of PR-AKI warrants a thorough understanding of the physiologic adaptations in the kidney and the ur...
Hairy Cell Leukemia – Variant (HCL-V): A Separate Entity
A female, aged 65 years had splenomegaly and atypical lymphocytes in blood smear. Atypical cells had large round nuclei. Flow cytometric (FCM ) findings revealed positivity of atypical cells for CD19, CD103 and CD11c ant...
The effect of nesting placement position on the gastric residual volume after gavage for premature neonates hospitalizedin the neonates intensive care unit (NICU)
Background: Nutrition in premature neonates is associated with many problems. Nurses can promote nutritional tolerance in premature neonates through interventions. In this study, we have tried to identify the situation w...