Echocardiographic Assessment of Cardiac Function in Liver Cirrhosis: A Cross-sectional Study

Abstract

Introduction: Echocardiography is a noninvasive method to assess the cardiac dysfunction in liver cirrhosis. Early detection of cardiac dysfunction helps prevent morbidity in patients undergoing haemodynamics altering procedures like liver transplant or Transjugular Intrahepatic Portosystemic Shunt (TIPSS) or those who have haematemesis. Aim: This study had been planned to assess the cardiac dysfunction and its incidence among patients of liver cirrhosis. Materials and Methods: In this cross-sectional study total of 150 individuals with liver cirrhosis were enrolled and cardiac assessment was done in the form of systolic and diastolic dysfunction by 2D Echocardiography. It was correlated with the aetiology and severity of liver cirrhosis was assessed by Child Pugh’s criteria. The grading of diastolic dysfunction was done on the basis of Early/Late (E/A) Left Ventricular (LV) filling ratio as Grade I (impaired relaxation pattern) E/A<0.8, Grade II (Pseudo normal) as E/A 0.8-1.5, and Grade III (Restrictive filling) E/A >2. Statistical analysis was done by using Chi-square test and Pearson’s Correlation Coefficient and p<0.05 is considered as level of significance. Results: Out of the 150 patients of liver cirrhosis, cardiac dysfunction was noted in 51. Among 93 (62%) patients who had alcoholic aetiology, 4 (44.4%) had systolic dysfunction whereas 29 (69.04%) had diastolic dysfunction. Among 9 patients of Left Ventricular (LV) systolic dysfunction 2 (22.2%) patients were in grade A Child Pugh, 4 (44.4%) in grade B and 3 (33.4%) in grade C, all being statically significant (r=0.195; p=0.017). LV diastolic dysfunction was seen in 17 (20.2%) of Grade A, 14 (25%) of Grade B and 11 (100%) of Grade C of Child Pugh Score, all being statistically significant and well correlated according to severity (r=0.199; p=0.004). Conclusion: The cardiac dysfunction was directly correlated with severity of liver cirrhosis according to Child Pugh scoring criteria thereby suggesting that possible cardiac changes were due to cirrhosis and not alcohol.