Incidence of Cardiovascular Dysfunction in Patients With Liver Cirrhosis - A Hospital Based Observational Study

Background: Liver cirrhosis is a chronic condition marked by scarring of liver tissue, leading to signicant functional impairment. Cardiovascular dysfunction, often referred to as cirrhotic cardiomyopathy, is a known complication in liver cirrhosis patients, characterized by altered cardiac structure and function. Our study aimed to elucidate the incidence and nature of cardiovascular abnormalities in this patient population. Aim: To study the incidence of cardiovascular dysfunction in patients with liver cirrhosis and its correlation with the severity of liver disease as classied by the Child-Pugh score. Material and Methods: An observational study was conducted at Mahatma Gandhi Medical College & Hospital, Jaipur, including 101 patients with liver cirrhosis, without any pre-existing cardiac ailments. Demographic data, liver disease severity (Child-Pugh classication), and various cardiac function parameters were recorded. Cardiac assessments included measurements of LV ejection fraction (EF), global longitudinal strain (GLS), septal e', E/e' ratio, TR velocity, systolic and diastolic function, QTc interval, and BNPlevels. Results:· Age and Gender:Patients ranged from 22 to over 50 years, with the majority (41.6%) over 50 years old. The cohort included 71 males (70.3%) and 30 females (29.7%). Child-Pugh Class: 62.4% of patients were in Class A, 23.8% in Class B, and 13.9% in Class C. Cardiac Function: 28.7% had an LV EF <50%, and 24.8% had GLS <18%, 23.8% had septal e'<7cm/second, 30.7% had E/e' >15, 28.7% had TR velocity >280cm/second. Systolic dysfunction was present in 23.8%, and diastolic dysfunction in 22.8%. Elevated QTc intervals (>440 ms) were found in 45.5%, and 60.4% had elevated BNP levels (>100 pg/mL). Associations: Signicant associations were found between higher Child-Pugh classes and both systolic and diastolic dysfunction (p-value = 0.001). Conclusion:This study highlights a signicant incidence of cardiovascular dysfunction in liver cirrhosis patients, particularly among those with more severe liver disease (Child-Pugh Classes B and C). Comprehensive cardiovascular assessment is crucial in this population for early detection and management of cardiac complications, potentially improving overall patient outcomes.