Cardiac changes in patients with chronic liver disease: A prospective descriptive study
Keywords:
Cardiomyopathy, Cirrhosis, chronic liver disease
Abstract
Background: The systemic circulation in patients with cirrhosis is hyperdynamic with an increased cardiac output and heart rate and a reduced systemic vascular resistance as the most pronounced alterations. The concomitant cardiac dysfunction has recently been termed “cirrhotic cardiomyopathy”, which is an entity different from that seen in alcoholic heart muscle disease.
Objective: To study cardiac changes in patients with chronic liver disease.
Methodology: The present study was a prospective descriptive clinical study consisting of thirty five patients with cirrhosis who were inpatients in the department of Medicine, tertiary care Institute, from Oct 2011 to Oct 2013.The patients were evaluated for presence of cirrhotic cardiomyopathy.
Results: In A group there is no patient, while in Child- Pugh Score- B group 14 subjects have cirrhotic cardiomyopathy out of 16 and in C group 18 have cirrhotic cardiomyopathy out of 19. We analyzed that there was no relation between severity of liver disease and cirrhotic cardiomyopathy (p value- 0.446).
Conclusion: Indian patients with cirrhosis do have diastolic dysfunction. In the absence of other risk factors for cardiac disease, this dysfunction can be attributed only to cirrhotic cardiomyopathy.
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References
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15. Perello A, Inserte J, Godoy A, et al. Cardiac structure and function in experimental intra-hepatic portal hypertension. [abstract] J Hepatol2000;32:65.
16. Wong F, Liu P, Tobe S, et al. Central blood volume in cirrhosis: measurement with radionuclide angiography. Hepatology1994;19:312–21.
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22. Keller H, Bezjak V, Stegaru B, Buss J, Holm E, Heene DL. Ventricular function in cirrhosis and portasystemic shunt: a two-dimensional echocardiographic study. Hepatology. 1988 May-Jun;8(3):658-62.
23. Estruch R, Fernández-Solá J, Sacanella E, Paré C, Rubin E, Urbano-Márquez A. Relationship between cardiomyopathy and liver disease in chronic alcoholism. Hepatology. 1995 Aug;22(2):532-8.
24. Laffi G, Barletta G, La Villa G, Del Bene R, Riccardi D, Ticali P, Melani L, Fantini F, Gentilini P. Altered cardiovascular responsiveness to active tilting in nonalcoholic cirrhosis.
25. Pozzi M, Carugo S, Boari G, Pecci V, de Ceglia S, Maggiolini S, Bolla GB, Roffi L, Failla M, Grassi G, Giannattasio C, Mancia G. Evidence of functional and structural cardiac abnormalities in cirrhotic patients with and without ascites. Hepatology. 1997 Nov;26(5):1131-7.
26. Valeriano V, Funaro S, Lionetti R, Riggio O, Pulcinelli G, Fiore P, Masini A, De Castro S, Merli M. Modification of cardiac function in cirrhotic patients with and without ascites. Am J Gastroenterol. 2000 Nov;95(11):3200-5. [PubMed]
27. Henriksen JH, Bendtsen F, Sørensen TI, Stadeager C, Ring-Larsen H. Reduced central blood volume in cirrhosis. Gastroenterology. 1989 Dec;97(6):1506-13. [PubMed]
28. Lewis FW, Adair O, Rector WG. Arterial vasodilation is not the cause of increased cardiac output in cirrhosis. Gastroenterology1992;102:1024–9.
2. Llach J, Ginés P, Arroyo V, et al. Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology1988;94:482–7. [PubMed]
3. Møller S, Wiinberg N, Hernriksen JH. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis. Hepatology. 1995 Jul;22(1):88-95. [PubMed]
4. Møller S, Henriksen JH. Circulatory abnormalities in cirrhosis with focus on neurohumoral aspects. Semin Nephrol. 1997 Nov;17(6):505-19. [PubMed]
5. Henriksen JH, Møller S, Ring-Larsen H, Christensen NJ. The sympathetic nervous system in liver disease. J Hepatol. 1998 Aug;29(2):328-41. [PubMed]
6. Levy M, Maher E, Wexler MJ. Euvolemic cirrhotic dogs in sodium balance maintain normal systemic hemodynamics. Can J Physiol Pharmacol. 1988 Jan;66(1):80-3.
7. Fernández-Rodriguez CM, Prieto J, Zozaya JM, Quiroga J, Guitián R. Arteriovenous shunting, hemodynamic changes, and renal sodium retention in liver cirrhosis. Gastroenterology. 1993 Apr;104(4):1139-45. [PubMed]
8. Epstein SK, Ciubotaru RL, Zilberberg MD, Kaplan LM, Jacoby C, Freeman R, Kaplan MM. Analysis of impaired exercise capacity in patients with cirrhosis. Dig Dis Sci. 1998 Aug;43(8):1701-7. [PubMed]
9. Fallon MB, Abrams GA. Pulmonary dysfunction in chronic liver disease. Hepatology. 2000 Oct;32(4 Pt 1):859-65. [PubMed]
10. Shah A, Variyam E. Pericardial effusion and left ventricular dysfunction associated with ascites secondary to hepatic cirrhosis. Arch Intern Med1988;148:585–8. [PubMed]
11. Ahmed SS, Howard M, ten Hove W, Leevy CM, Regan TJ. Cardiac function in alcoholics with cirrhosis: absence of overt cardiomyopathy--myth or fact? J Am Coll Cardiol. 1984 Mar;3(3):696-702. [PubMed]
12. Møller S, Søndergaard L, Møgelvang J, Henriksen O, Henriksen JH. Decreased right heart blood volume determined by magnetic resonance imaging: evidence of central underfilling in cirrhosis. Hepatology. 1995 Aug;22(2):472-8. [PubMed]
13. Friedman HS, Fernando H. Ascites as a marker for the hyperdynamic heart of Laennec's cirrhosis. Alcohol Clin Exp Res. 1992 Oct;16(5):968-70. [PubMed]
14. Wong F, Liu P, Lilly L, Bomzon A, Blendis L. Role of cardiac structural and functional abnormalities in the pathogenesis of hyperdynamic circulation and renal sodium retention in cirrhosis. Clin Sci (Lond). 1999 Sep;97(3):259-67.
15. Perello A, Inserte J, Godoy A, et al. Cardiac structure and function in experimental intra-hepatic portal hypertension. [abstract] J Hepatol2000;32:65.
16. Wong F, Liu P, Tobe S, et al. Central blood volume in cirrhosis: measurement with radionuclide angiography. Hepatology1994;19:312–21.
17. Rector WG Jr, Hossack KF. Pathogenesis of sodium retention complicating cirrhosis: is there room for diminished “effective” arterial blood volume?Gastroenterology1988;95:1658–63.
18. Dancy M, Bland JM, Leech G, Gaitonde MK, Maxwell JD. Preclinical left ventricular abnormalities in alcoholics are independent of nutritional status, cirrhosis, and cigarette smoking. Lancet. 1985 May 18;1(8438):1122-5. [PubMed]
19. Kelbaek H, Eriksen J, Brynjolf I, Raboel A, Lund JO, Munck O, Bonnevie O, Godtfredsen J. Cardiac performance in patients with asymptomatic alcoholic cirrhosis of the liver. Am J Cardiol. 1984 Oct 1;54(7):852-5. [PubMed]
20. Rector WG Jr, Robertson AD, Lewis FW, Adair OV. Arterial underfilling does not cause sodium retention in cirrhosis. Am J Med. 1993 Sep;95(3):286-95. [PubMed]
21. Rector WG Jr, Adair O, Hossack KF, et al. Atrial volume in cirrhosis: relatioship to blood volume and plasma concentrations of atrial natriuretic factor.Gastroenterology1990;99:766–70.
22. Keller H, Bezjak V, Stegaru B, Buss J, Holm E, Heene DL. Ventricular function in cirrhosis and portasystemic shunt: a two-dimensional echocardiographic study. Hepatology. 1988 May-Jun;8(3):658-62.
23. Estruch R, Fernández-Solá J, Sacanella E, Paré C, Rubin E, Urbano-Márquez A. Relationship between cardiomyopathy and liver disease in chronic alcoholism. Hepatology. 1995 Aug;22(2):532-8.
24. Laffi G, Barletta G, La Villa G, Del Bene R, Riccardi D, Ticali P, Melani L, Fantini F, Gentilini P. Altered cardiovascular responsiveness to active tilting in nonalcoholic cirrhosis.
25. Pozzi M, Carugo S, Boari G, Pecci V, de Ceglia S, Maggiolini S, Bolla GB, Roffi L, Failla M, Grassi G, Giannattasio C, Mancia G. Evidence of functional and structural cardiac abnormalities in cirrhotic patients with and without ascites. Hepatology. 1997 Nov;26(5):1131-7.
26. Valeriano V, Funaro S, Lionetti R, Riggio O, Pulcinelli G, Fiore P, Masini A, De Castro S, Merli M. Modification of cardiac function in cirrhotic patients with and without ascites. Am J Gastroenterol. 2000 Nov;95(11):3200-5. [PubMed]
27. Henriksen JH, Bendtsen F, Sørensen TI, Stadeager C, Ring-Larsen H. Reduced central blood volume in cirrhosis. Gastroenterology. 1989 Dec;97(6):1506-13. [PubMed]
28. Lewis FW, Adair O, Rector WG. Arterial vasodilation is not the cause of increased cardiac output in cirrhosis. Gastroenterology1992;102:1024–9.
CITATION
DOI: 10.17511/ijmrr.2016.i04.16
Published: 2016-04-30
How to Cite
1.
Sukhwani N, Nayak OP, Kumbhkar T. Cardiac changes in patients with chronic liver disease: A prospective descriptive study. Int J Med Res Rev [Internet]. 2016Apr.30 [cited 2024Apr.25];4(4):569-74. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/519
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