A study on cardiac dysfunction in nonalcoholic cirrhosis

Author: 
Kandasamy alias Kumar. E., Caroline Selvi. K and Venkateswaran. A.R

AIM :To study the presence of cardiac dysfunction namely Cirrhotic cardiomyopathy in a tertiary care centre and to assist in stratification of Cirrhotic cardiomyopathy .To assess the impact of QTc prolongation and ascites in Cirrhotic cardiomyopathy. To evaluate the problem in non alcoholic group. MATERIALS AND METHODS: Inclusion criteria: patients with non alcoholic cirrhosis were included in the study. Exclusion criteria: Alcoholics,severe ascites, patients with risk factors for cardiomyopathy other than cirrhosis and metabolic disorders were excluded from the study.Investigation like CBC,LFT,USG with Doppler, Viral markers, ECG, Echocardiography were done. The parameters that were assessed in Echocardiography are E/a ratio, end diastolic volume, end systolic volume, Ejection fraction. RESULTS: Total number of cases: 45, Female-41(91.1%); male-4 (8.9%). CTP score distribution: ClassA:29 (64.4%), ClassB:16 (35.6%) ,ClassC: Nil. Presence of Ascites: 37 had and 8 did not have ascites. Presence of Varices: 40 had and 5 did not have varices. Conduction disturbances: 25 had QTc interval more than440msec and 20 had less than 440msec. Presence of Left ventricular dysfunction (E/A ratio): Of the 45 casesE/Aratio (early diastolic and Late diastolic atrial filling velocity) was less than 1 in 38(84.4%) cases and more than 1 in 7(15.6%) patients. Of the 45cases included in the study 40 patients (88.9%) had features of Cirrhotic cardiomyopathy. CONCLUSIONS: Cirrhosis of Non-alcoholic aetiology have evidence of Cirrhotic cardiomyopathy. Cirrhotic cardiomyopathy independent of the aetiology.Severity of the liver disease correlated to the degree of QTc prolongation. Ascites is a significant feature of all cases with diastolic dysfunction.Gender does not have correlation with the presence of Cirrhotic cardiomyopathy.Some degree of Diastolic dysfunction is seen in almost all cirrhotics. Ventricular end diastolic volume, end systolic volume and ejection fraction are not significantly affected in cirrhotic individuals.

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