PREVALENCE OF CARDIOMYOPATHY IN PATIENTS WITH LIVER CIRRHOSIS, CROSS-SECTIONAL STUDY.

Abstract

Introduction: Dysfunction of the liver gives rise to many complications, one of which is “cirrhotic cardiomyopathy”. Its prevalence in the United States population is >40%. In Pakistan, the prevalence is not well documented however; some studies estimated it to be 20-45%. The results of this study will provide baseline data on the burden of cardiomyopathy in cirrhotic patients which will help in the early management of cardiomyopathy among patients of cirrhosis. Methods: This descriptive study was conducted at the medical intensive care unit of Jinnah Postgraduate Medical Centre Karachi, Pakistan from 16-1-2018 to 15-1-2019 taking a sample of 95 patients of either sex, 25-60 years of age, diagnosed cirrhotic for >5 years and with Child-Pugh classification C. Patients with prior history of heart diseases and drug intake (such as calcium channel blockers, antiarrhythmics, and digoxin) were excluded. Results: 83 were males (87.36%) with a male-female ratio of 6.9:1. The mean age was 47±9.1 years. E/A ratio <1 was present in 80 (84.20%) cases, QT interval >0.44 seconds present in 87 (91.60%) cases and ejection fraction >55% in 83 (87.40%) cases. Cirrhotic cardiomyopathy was detected in 72 (75.78%) cases. Age and gender were non-significant (p= 0.218 & 0.321 respectively) while Child-Pugh class, E/A ratio, QT interval, and ejection fraction were significant effect modifiers on the frequency of cardiomyopathy among cirrhotic patients (p<0.0001). Conclusion: Pakistani 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.