Abstract
Objectives
This study aims at estimating the prevalence of cirrhotic cardiomyopathy in a cohort of cirrhosis patients in northern India using the World Congress of Gastroenterology 2005 criteria and its relationship with grades of cirrhosis, its complications, and all-cause mortality.
Methods
This was a prospective study in which 53 cirrhosis patients underwent the 2D color Doppler, and tissue Doppler echocardiography. Echocardiography findings were compared with thirty age- and sex-matched healthy controls. Additionally, serum pro-brain natriuretic peptide (pro-BNP) and troponin-T levels were measured. Patients were followed up for 6 months to look for complications and mortality.
Result
2D echocardiography findings revealed that diastolic cardiomyopathy with no gross systolic dysfunction was significantly prevalent in cirrhosis patients. Using the Montreal criteria, we found the incidence of diastolic cardiomyopathy to be 56.6%. Tissue Doppler echocardiography findings were also correlated. Diastolic dysfunction correlated with the severity of cirrhosis, and patients with higher Child score had more diastolic dysfunction. Serum pro-BNP levels and QTc interval were also higher in patients with diastolic dysfunction. On survival analysis, patients with cirrhotic cardiomyopathy had shorter survival and greater frequency of encephalopathy and hepatorenal syndrome (HRS) episodes as compared with cirrhotic patients without cardiomyopathy, though the differences were not statistically significant.
Conclusion
The study showed that diastolic dysfunction was highly prevalent (56.6% of the study population) in cirrhosis patients. QTc interval and pro-BNP were also significantly raised. Also, complications of cirrhosis like HRS, spontaneous bacterial peritonitis, and hepatic encephalopathy were more common in the cirrhotic cardiomyopathy group.
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Funding
MD Thesis grant awarded to Dr. Neha Kapoor.
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1. N Kapoor: concept and design of study, acquisition and analysis of data, drafting of manuscript and revising it critically for important intellectual content, final approval of manuscript. 2. V Mehta: acquisition and analysis of data, drafting of manuscript and revising it critically for important intellectual content. 3. B Singh: acquisition and analysis of data, drafting of manuscript and revising it critically for important intellectual content. 4. R Karna: drafting of manuscript and revising it critically for important intellectual content. 5. S Kumar: concept and design of the study, final approval of manuscript. 6. P Kar: concept and design of the study, drafting of manuscript and revising it critically for important intellectual content, final approval of manuscript.
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NK, VM, BS, RK, SK, and PK declare that they have no conflict of interest.
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The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.
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Kapoor, N., Mehta, V., Singh, B. et al. Prevalence of cirrhotic cardiomyopathy and its relationship with serum pro-brain natriuretic peptide, hepatorenal syndrome, spontaneous bacterial peritonitis, and mortality. Indian J Gastroenterol 39, 481–486 (2020). https://doi.org/10.1007/s12664-020-01083-2
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DOI: https://doi.org/10.1007/s12664-020-01083-2