Cardiac health in patients with hepatitis B virus-related cirrhosis

Wei Yuan1, Hong-Zhou Lu2, Xue Mei1

  • 1Department of Liver Intensive Care Unit.

Medicine
|March 29, 2019
PubMed

Insights

Hepatitis B virus (HBV) related cirrhosis commonly impairs cardiac health, even in patients without typical heart disease symptoms. This study found impaired cardiac function and exercise tolerance worsen with liver disease severity, highlighting the need for cardiac consideration in cirrhosis management.

Area of Science:

  • Hepatology
  • Cardiology
  • Internal Medicine

Background:

  • Cirrhosis, regardless of etiology, is linked to cardiac dysfunction.
  • Hepatitis B virus (HBV) infection is a common cause of nonalcoholic cirrhosis, with potential cardiac implications.
  • Cardiac health in HBV-related cirrhotic patients without overt cardiac symptoms requires investigation.

Purpose of the Study:

  • To noninvasively evaluate cardiac function in HBV-related cirrhotic patients.
  • To assess exercise performance in this patient group.
  • To identify cardiac dysfunction and its association with liver disease severity.

Main Methods:

  • Recruited 79 HBV-related cirrhotic patients and 103 controls.
  • Performed clinical examinations and noninvasive cardiac health evaluations.
  • Investigated incidence, risk factors of cardiac dysfunction, and exercise tolerance.

Main Results:

  • A correlation was found between QTc interval and Model for End-Stage Liver Disease (MELD) score (P=.018).
  • 51.90% of patients met criteria for cirrhotic cardiomyopathy, with increased cardiac diastolic dysfunction (CDD) correlating with higher Child-Pugh grades (P=.004).
  • Higher Child-Pugh scores predicted CDD (OR=1.662, P=.010), and both cardiac function and exercise tolerance declined with increasing liver disease severity.

Conclusions:

  • Impaired cardiac health, including diastolic dysfunction, is prevalent in HBV-related cirrhotic patients.
  • Cardiac factors should be integrated into the comprehensive management of cirrhosis.
  • Hepatology physicians should emphasize exercise training for these patients.

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