PREVELANCE OF LEFT VENTERICULER DIASTOLIC DYSFUNCTION IN LIVER CIRRHOSIS
Asmaa Abd El khalik Sleem Othman;
Abstract
SUMMARY
L
iver cirrhosis is associated with a wide range of cardiovascular abnormalities. These abnormalities include hyper dynamic circulation characterized by an increase in cardiac output and a decrease in peripheral vascular resistance. Despite the increased cardiac output, impaired ventricular contractility in response to both physiological and pharmacological stimuli has been described. Other cardiac abnormalities include structural changes including enlargement or hypertrophy of different cardiac chambers and electrophysiological changes such as QT prolongation. This constellation of cardiac abnormalities is termed cirrhotic cardiomyopathy.
Ventricular diastolic compliance and diastolic function can be assessed by measuring the velocity of blood flow from the left atrium to the left ventricle during early diastole (the E wave) and late diastole (the A wave) and calculating the E/A ratio by using the doppler echocardiography.
The present study was done in order to investigate the diastolic function changes prevalence in viral related liver cirrhosis. It was performed on sixty patients with HCV liver cirrhosis.
Full history and clinical examination were done to all patients and patients with history of cardiac disease were excluded from the study.
Laboratory investigations including complete liver function tests: (Aspartate transaminase (AST), Alanine transaminase (ALT), and albumin, bilirubin and INR were done to all patients.
They were subdivided according to liver function groups:
1. Group A was 30 patients with Compensated Liver cirrhosis disease (child A) 16 (53.3 %) females and 14 (46.7 %) males the age ranged between (38-60) years with mean age (51.526.06), 7(29.2%) with diastolic dysfunction and 23(41,1%) with non diastolic dysfunction
2. Group B was 30 patient with Decompensate Liver cirrhosis disease (Child B&C) 14 (46.7%) females and 16 (53.3%) males, the age ranged between 39-60 years with mean age (50.376.15) ), 17(70.8%) with diastolic dysfunction and 13 (23.2%) with non diastolic dysfunction.
3. Control group of twenty 11 (55%) females and 9 (45%) males, the age ranged between 40-55 years with mean age (48.83.27).all had non diastolic dysfunction.
Echocardiography was done to all patients to detect left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), ejection fraction (EF%) and E/A ratio to detect the presence of diastolic dysfunction and revealed decrease in the LVESD and EF% in patients who developed diastolic dysfunction more than the patients who had non diastolic dysfunction.
In this study decreased E/A ratio as indicator for diastolic dysfunction was found in 24(40%) patients while patients had normal E/A ratio was 36(60%).
E/A ratio decreased in cirrhotic patients with decompensated liver cirrhosis more than those with compensated liver cirrhosis.
L
iver cirrhosis is associated with a wide range of cardiovascular abnormalities. These abnormalities include hyper dynamic circulation characterized by an increase in cardiac output and a decrease in peripheral vascular resistance. Despite the increased cardiac output, impaired ventricular contractility in response to both physiological and pharmacological stimuli has been described. Other cardiac abnormalities include structural changes including enlargement or hypertrophy of different cardiac chambers and electrophysiological changes such as QT prolongation. This constellation of cardiac abnormalities is termed cirrhotic cardiomyopathy.
Ventricular diastolic compliance and diastolic function can be assessed by measuring the velocity of blood flow from the left atrium to the left ventricle during early diastole (the E wave) and late diastole (the A wave) and calculating the E/A ratio by using the doppler echocardiography.
The present study was done in order to investigate the diastolic function changes prevalence in viral related liver cirrhosis. It was performed on sixty patients with HCV liver cirrhosis.
Full history and clinical examination were done to all patients and patients with history of cardiac disease were excluded from the study.
Laboratory investigations including complete liver function tests: (Aspartate transaminase (AST), Alanine transaminase (ALT), and albumin, bilirubin and INR were done to all patients.
They were subdivided according to liver function groups:
1. Group A was 30 patients with Compensated Liver cirrhosis disease (child A) 16 (53.3 %) females and 14 (46.7 %) males the age ranged between (38-60) years with mean age (51.526.06), 7(29.2%) with diastolic dysfunction and 23(41,1%) with non diastolic dysfunction
2. Group B was 30 patient with Decompensate Liver cirrhosis disease (Child B&C) 14 (46.7%) females and 16 (53.3%) males, the age ranged between 39-60 years with mean age (50.376.15) ), 17(70.8%) with diastolic dysfunction and 13 (23.2%) with non diastolic dysfunction.
3. Control group of twenty 11 (55%) females and 9 (45%) males, the age ranged between 40-55 years with mean age (48.83.27).all had non diastolic dysfunction.
Echocardiography was done to all patients to detect left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), ejection fraction (EF%) and E/A ratio to detect the presence of diastolic dysfunction and revealed decrease in the LVESD and EF% in patients who developed diastolic dysfunction more than the patients who had non diastolic dysfunction.
In this study decreased E/A ratio as indicator for diastolic dysfunction was found in 24(40%) patients while patients had normal E/A ratio was 36(60%).
E/A ratio decreased in cirrhotic patients with decompensated liver cirrhosis more than those with compensated liver cirrhosis.
Other data
Title | PREVELANCE OF LEFT VENTERICULER DIASTOLIC DYSFUNCTION IN LIVER CIRRHOSIS | Other Titles | نسبة وجود خلل فى الوظيفة الانبساطية للبطين الايسر للقلب فى مرضى التليف الكبدى | Authors | Asmaa Abd El khalik Sleem Othman | Issue Date | 2016 |
Attached Files
File | Size | Format | |
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G11211.pdf | 469.36 kB | Adobe PDF | View/Open |
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