Frequency of cirrhotic cardiomyopathy in patients with cirrhosis of liver: A tertiary care hospital experience

Samiullah Shaikh, Mukhtiar Abro, Iftikhar Qazi, Akbar Yousfani


Objective: To determine the frequency of cirrhotic cardiomyopathy in patients with liver cirrhosis.
Methodology: This Descriptive case series study was conducted in  Medical Department of Liaquat University Hospital Jamshoro / Hyderabad from 3rd January 2009 to 16th June 2009.This study included 74 consecutive  cases of cirrhosis of liver of either sex above 14 years of age. Firstly, resting ECG was done in all the patients. QTc values were calculated from lead II. QTc interval of > 0.44 sec were considered as prolonged. Systolic dysfunction was assessed by ejection fraction (value of >55% was considered as increased). Diastolic dysfunction manifested by reduced E/A ratio (< 1 was considered as decreased). Thirdly, all patients had determination of proBNP levels. The presence of cirrhotic cardiomyopathy was confirmed by abnormal ECG or echocardiography, along with proBNP abnormalities. Statistical package for social sciences (SPSSTM) version 16 was used for data processing purpose. Means ±Standard Deviation of age and pro BNP levels were calculated. Frequency and percentage were computed for cirrhotic cardiomyopathy in cirrhosis patients.
Results: A total of 74 patients were selected for this study, out of which 41 (55.41%) were male and 33 (44.59%) were female. The mean age was 46.2 years (± 10.8 SD). Out of 74 patients 9 (12.2%) belonged to child Pugh A, 29(39.2%) to child-Pugh B and 36(48.6%) in child-Pugh C. Elevated pro BNP was present in 42(56.8%) cases, E/A ratio < 1 in 15 (20.3%) cases, prolong QT interval (>0.44sec) in 16 (21.6%), Ejection fraction (EF) > 0. 55 was present in 25 (33.8%) patients. Cirrhotic cardiomyopathy was present in 33(44.6%) cases. A strong relation was found between cardiomyopathy and severity of cirrhosis of liver (p=0.001), pr0-Bnp levels (p=0.003), QTc > 44 sec (0.004), Ejection fraction > 55% (0.004) and E/A ratio < 1 (p=0.005).
Conclusion: Cirrhotic cardiomyopathy was present in a sizeable proportion of cirrhotic patients, more so in the later stages of cirrhosis of liver.

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