Cirrhotic Cardiomyopathy: a cross-sectional study to know the frequency and its correlation with the severity of cirrhosis and other factors

Abstract

Background: Cirrhotic cardiomyopathy (CCM) is a cardiac dysfunction in the patients of cirrhosis. It is associated with increased morbidity and mortalitybecause of heart failure following invasive procedures. The present study aimed to determine the frequency of cirrhotic cardiomyopathy and its correlation with the spectrum of disease severity, Pro-BNP levels & other factors.

Material and Method: This cross-sectional study included 50 cirrhotic patients. All the demographic variables, biochemical test results and ECG findings were noted. Cardiac functions were assessed by echocardiography.The severity of cirrhosis was assessed by Child-Turcotte-Pugh(CTP) score and Model for end-stage liver disease (MELD) score. All the collected continuous and categorical data was represented as mean/standard deviation and frequency/percentage. The association between CCM and different parameters were assessed by Chi-square test and ANOVA test.

Results: Among 50 cirrhotic patients, systolic dysfunction was observed in 52% (n=26), diastolic dysfunction in 72% (n=36) and prolonged QTc in 78% cases (n=39)of cirrhotic patients. A total of 34 patients (68%) had CCM. The raised Pro-BNP level was observed in 70% (n=35) of patients. The CTP stage A, B and C was observed in 14%, 48% and 38% of cases respectively. Frequency of CCM was significantly increased with severity of cirrhosis as it was most frequent in CTP-C stage (p=0.001). Demographic variables (such as age, gender and BMI), etiologies and other biochemical parameters were not significantly different in patient with or without CCM. However, CCM patients had a significantly higher CTP score, MELD score and Pro -BNP level.

Conclusion: The Cardiac dysfunctions were more prevalent in higher stages of cirrhosis.  The presence of CCM was not related to etiology of cirrhosis whereas; it is directly correlated with higher CTP score, MELD score and Po-BNP levels.

Keyword: Cirrhotic cardiomyopathy, CTP score, MELD score, QTc interval, Pro-BNP.