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Anatomical cardiac alterations in liver cirrhosis: an autopsy study
Nayeli X Ortiz-Olvera1, Guillermo Castellanos-Pallares, Luz M Gómez-Jiménez
1Gastroenterology Department, UMAE Hospital de Especialidades, CMN Siglo XXI, IMSS, Mexico City, Mexico. nayelixoortiz@yahoo.com.mx
Insights
Liver cirrhosis (LC) is frequently associated with cardiac abnormalities, affecting 43% of patients in this autopsy study. These include cardiomegaly and left ventricular hypertrophy, regardless of cirrhosis cause.
Area of Science:
- Cardiology
- Hepatology
- Pathology
Background:
- Liver cirrhosis (LC) may be linked to anatomical cardiac changes, irrespective of its cause.
- Understanding these associations is crucial for comprehensive patient management.
Purpose of the Study:
- To determine the prevalence and types of macroscopic anatomical cardiac abnormalities (MACA) in patients with alcoholic and non-alcoholic liver cirrhosis.
- To analyze cardiac findings in a postmortem series.
Main Methods:
- Reviewed 1,176 autopsy records from 1990-2002.
- Included 135 cases diagnosed with liver cirrhosis, excluding those with pre-existing heart disease.
- Analyzed demographic data, cirrhosis etiology, and identified MACA.
Main Results:
- 43% of liver cirrhosis patients exhibited MACA, with higher rates in alcoholic cirrhosis (47%) and those with ascites (62%).
- Common findings included cardiomegaly and left ventricular hypertrophy (LVH).
- Hepatitis C virus (HCV) infection and chronic alcohol abuse were leading cirrhosis etiologies.
Conclusions:
- The study confirms a high incidence of cardiac abnormalities in liver cirrhosis patients.
- These cardiac alterations occur irrespective of the underlying cause of cirrhosis.
Background:
It has been suggested that liver cirrhosis (LC), regardless of etiology, may be associated with anatomical cardiac alterations.
Objective:
To describe the frequency and type of macroscopical anatomic cardiac abnormalities present in alcoholic and non-alcoholic cirrhotic patients in an autopsy series.
Material And Methods:
The autopsy records performed at our institution during a 12-year period (1990-2002) were reviewed. All cases with final diagnosis of LC were included, their demographic characteristics as well as cirrhosis etiology and macroscopic anatomical cardiac abnormalities (MACA) analyzed. Patients with any known history of heart disease prior to diagnosis of cirrhosis were excluded.
Results:
A total of 1,176 autopsies were performed, of which 135 cases (11.5%) were patients with LC. Two patients with cardiac cirrhosis were excluded. Chronic alcohol abuse (29%) and chronic hepatitis due to hepatitis C virus (HCV) infection (20%) were the most common causes of cirrhosis. The etiology was not identified in 35% of the cases, even after exhaustive clinical, serological and/or radiological assessment. In the postmortem analysis, 43% of the cases were informed to have MACA (47% in the group of patients with alcoholic cirrhosis and 41% in other types of cirrhosis); this rate increased to 62% in patients with ascites. The most frequent alterations were cardiomegaly and left ventricular hypertrophy (LVH).
Conclusion:
The results confirm the high frequency of cardiac abnormalities in patients with cirrhosis, regardless of cirrhosis etiology.
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