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
Effectiveness of Epley’s Manoeuvre in Benign Paroxysmal Positional Vertigo- A Prospective Study
Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo. The patient complains of brief but severe episodes of rotatory vertigo lasting less than a minute upon sudden changes...
Cesarean Section from posterior wall of uterus?????
Torsion of the pregnant uterus, at term, is a very rare event in obstetric practice. It is associated with high perinatal mortality but in our case report the torsion remained asymptomatic till 3rd trimester. We report a...
Role of CT Perfusion in Differentiation between High and Low Grade Glioma
Gliomas, the most common primary brain neoplasms in adults, are very heterogeneous tumors. High-grade gliomas can be highly invasive and extremely vascular tumors. (1) Glioma grading is currently based on the histopathol...
A Comparative Study of Laparoscopic vs. Open Cholecystectomy in a Northwestern Medical School of Bihar
Introduction: Gallstones are common in Indian population and its treatment has shown a decisive shift from open to minimally invasive route. Undoubtedly, laparoscopy requires longer and steeper learning curve and incurs...
Conn’s Syndrome Masquerading as Hypokalemic Paralysis
Hypertension is a globally prevalent disease with significant morbidity and mortality. While the usual presentation is non- specific, or related to end-organ symptoms like dizziness, headache, encephalopathy, cerebrovasc...