Cardiac Dysfunction in Patients with Liver Cirrhosis

Area of Science:

• Cardiology
• Hepatology
• Internal Medicine

Background:

• Cirrhosis complications like ascites and varices are well-known.
• Cardiac dysfunction in cirrhosis is under-recognized but significantly impacts morbidity and mortality.
• This dysfunction is often asymptomatic at rest, manifesting during stress or interventions.

Purpose of the Study:

• To investigate the prevalence and characteristics of cardiac dysfunction in patients with cirrhosis.
• To assess the relationship between cardiac dysfunction and liver disease severity.
• To identify potential early indicators of cardiac dysfunction in cirrhotic patients.

Main Methods:

• Cross-sectional study conducted at Bir Hospital's Liver Unit (May 2015-May 2016).
• Diagnosis of cirrhosis confirmed via clinical, lab, ultrasound, endoscopic, and/or biopsy data.
• Cardiac function assessed using resting pulse, mean arterial pressure, ECG, and 2D echocardiography; liver function evaluated with Child-Pugh and MELD scores.

Main Results:

• Diastolic dysfunction observed in 61.9% of patients, more frequent in alcoholic cirrhosis.
• Systolic dysfunction noted in 6.6% of alcoholic patients.
• 51.4% met criteria for cirrhotic cardiomyopathy; 79% exhibited prolonged QTc interval (>0.44s), especially in Child-Pugh C and MELD >10.

Conclusions:

• Cardiac dysfunction, primarily diastolic, is prevalent in cirrhosis, irrespective of the cause.
• QTc prolongation may serve as an early marker for cardiac dysfunction in cirrhosis.
• QTc prolongation correlates directly with Child-Pugh and MELD scores, indicating severity.