Retrospective analysis of liver cirrhosis influence on heart walls thickness.

OBJECTIVE

Cirrhotic cardiomyopathy is a chronic cardiac dysfunction in patients with liver cirrhosis. It is mostly characterized by impaired cardiac function, but some myocardial anatomical changes have also been described. The aim of this study was to assess the influence of liver cirrhosis on heart wall thickness changes in a retrospective pathological analysis of cirrhotic patients without hypertension.

MATERIALS AND METHODS

Statistical analysis of 11,860 autopsy protocols drawn up between 1981 and 2002 in the Department of Pathology Medical University of Warsaw was done.

RESULTS

Liver cirrhosis was confirmed by autopsy in 802 patients (6.7%); in 697 patients, hypertension was excluded. Analysis of heart wall thickness showed pathological changes in 53.2% of patients - left ventricular thickening in 9.3%, right ventricular thinning in 31.0%, and both in 12.9%. In clinical assessment, the cause of death in 25.8% of patients was cardiocirculatory failure, significantly more in the group with selective left ventricular thickening. It was the most common cause of death among them. Vascular changes in the upper gastrointestinal tract, liver enlargement and hepatic coma were also significantly related to the heart wall thickness changes occurrence.

CONCLUSIONS

Based on statistical analysis of autopsy material, we concluded that liver cirrhosis can lead to heart wall thickness changes (left ventricular thickening and/or right ventricular thinning). We revealed that patients with selective left ventricular thickening had significantly more cardiac related causes of death. In clinical practice, treatment of cirrhotic cardiomyopathy requires specialized diagnostics and appropriate cardiological procedures involving the participation of a hepatologist, especially in the group of patients with selective left ventricular hypertrophy.