Naqvi Iftikhar Haider, Mahmood Khalid, Naeem Muhammad, Vashwani Aneel Sham, Ziaullah Syed
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Prz Gastroenterol. 2016;11(4):247-256. doi: 10.5114/pg.2016.57962. Epub 2016 Feb 16.
Cirrhotic cardiomyopathy is a visor complication among patients with cirrhosis of the liver, manifesting during stress, exertion, transjuglar intrahepatic portosystemic shunt (TIPS), or liver transplantation. Cirrhotic cardiomyopathy is reported to be most common cause of post transplant mortality after rejection of 7% to 21%.
To determine the frequency of cirrhotic cardiomyopathy and was further designed to compare parameters of cardiac dysfunction in patients with or without cirrhotic cardiomyopathy.
All confirmed cases of cirrhosis with various aetiologies were enrolled. Resting ejection fraction (EF) was determined in all patients. Patients were grouped with resting EF < 55% (suspected cardiomyopathy) or > 55% (without cardiomyopathy). Stress echocardiography with dobutamine infusion in both groups yielded an increase of less than 10% in left ventricular (LV) EF at peak dobutamine infusion confirming systolic dysfunction. The diastolic dysfunction (E/A ratio), electrocardiographic parameter (prolong QT interval), and cardiac biomarker (NT-proBNP) were also determined in both the groups to confirm cirrhotic cardiomyopathy.
Among 89 patients with cirrhosis, 35 (39.32%) had cirrhotic cardiomyopathy. All components of cirrhotic cardiomyopathy, like systolic dysfunction, diastolic dysfunction, prolong QT interval, and cardiac biomarkers, were found to be statistically significant ( = 0.001) when compared with patients without cardiomyopathy. Cirrhotic cardiomyopathy parameters were positively correlated with advancing liver disease.
Cirrhotic cardiomyopathy is a frequent but unmasked complication in cirrhosis of the liver. All components of cardiac dysfunction, such as systolic, diastolic, and electrocardiographic changes, are present in patients with cirrhotic cardiomyopathy. Cirrhotic cardiomyopathy is positively correlated to severity of liver disease.
肝硬化性心肌病是肝硬化患者中一种隐匿性并发症，在应激、劳累、经颈静脉肝内门体分流术（TIPS）或肝移植期间表现出来。据报道，肝硬化性心肌病是移植后死亡率仅次于排斥反应的最常见原因，死亡率为7%至21%。
确定肝硬化性心肌病的发生率，并进一步比较有无肝硬化性心肌病患者的心脏功能障碍参数。
纳入所有确诊的各种病因的肝硬化病例。测定所有患者静息射血分数（EF）。患者按静息EF<55%（疑似心肌病）或>55%（无心肌病）分组。两组患者静脉注射多巴酚丁胺进行负荷超声心动图检查，结果显示在多巴酚丁胺注射峰值时左心室（LV）EF增加小于10%，证实存在收缩功能障碍。还测定了两组患者的舒张功能障碍（E/A比值）、心电图参数（QT间期延长）和心脏生物标志物（NT-proBNP），以确诊肝硬化性心肌病。
在89例肝硬化患者中，35例（39.32%）患有肝硬化性心肌病。与无心肌病患者相比，肝硬化性心肌病的所有组成部分，如收缩功能障碍、舒张功能障碍、QT间期延长和心脏生物标志物，均具有统计学意义（P = 0.001）。肝硬化性心肌病参数与肝病进展呈正相关。
肝硬化性心肌病是肝硬化中常见但未被发现的并发症。肝硬化性心肌病患者存在心脏功能障碍的所有组成部分，如收缩、舒张和心电图改变。肝硬化性心肌病与肝病严重程度呈正相关。
