Comparison of B Type Natriuretic Peptide and Echocardiographic Findings among Patients with Various Stages of Liver Diseases

Background and study aim: Cirrhotic cardiomyopathy of cirrhotic patients without heart diseases is a chronic cardiac ‎disorder with impaired cardiac contractility, responding to stress as well as altered diastolic ‎relaxation. More studies are required to address unanswered questions, including consensus ‎definition, particular diagnostic tests, exact prevalence of such syndrome in addition to ‎proper management approaches. Herein, we aimed at determining prevalence regarding ‎cirrhotic cardiomyopathy in our patients and improving early diagnosis of this syndrome‎. Patients and methods: ‎72 chronic liver disease (CLD) patients were recruited from gastroenterology department of ‎Suez Canal University Hospital, Ismailia, Egypt. The patients were then divided into three ‎main groups according to Child-Pugh criteria, and each group included 24 patients. All ‎patients underwent a medical history assessment and clinical examination, laboratory ‎investigations involving BNP levels, ECG in addition to echocardiography ‎‎‎.‎ Results: QTc interval prolongation was present in 56% of our decompensated cirrhotic patients. ‎Diastolic dysfunction exhibiting different grades (grade I- II) was found in most cirrhotic ‎patients (82%) in this study, while LT atrial dilatation with different grades (mild to severe) ‎was found in 69% of patients. Increased Child-Pugh class was significantly associated (p-‎value <0.05) with cirrhotic patients holding ECG abnormalities, diastolic dysfunction, in ‎addition to increased BNP levels and left atrial diameter‎. Conclusion: Herein, we demonstrated a statistically significant correlation in patients with cirrhosis ‎between cardiac dysfunction and cirrhosis severity. BNP may be an early marker to ‎identify cirrhotic cardiomyopathy's latent entity‎‎‎.