بررسي يافته هاي اكوكارديوگرافيك قلبي در بيماران سيروز كبدي

EVALUATION OF ECHO CARDIOGRAPHIC FINDINGS IN CIRRHOTIC PATIENTS

Introduction: Cardiovascular abnormalities have been reported in liver cirrhosis (LC). In these patients, cardiac symptoms and physical signs occur as the liver functions worsen. Cirrhosis is associated with hyper dynamic circulation and beta-adrenergic system changes responsible for the cardiovascular abnormalities. The purpose of the present study was to explore the echocardiographic findings in cirrhotic patients. Methods: A total of 90 patients (63 men, 27 women) with imaging or biopsy-proven cirrhosis of various etiologies without any known cardiac dysfunction were included in the study. Ninety healthy persons of the same age and sex were enrolled as the control group. Cirrhotic patients and controls were investigated by echocardiography. Left ventricle diastolic function (E/A ratio), systolic function (ejection fraction), and wail thickness (left ventricle posterior wall thickness + interventricular septum thickness) along with left and right ventricular dimensions were evaluated. Results: Right & left atrium and ventricle diameters were enlarged in 3 cirrhotic patients and the EA ratio was decreased in class C patients (0.9 ± 0.2) as compared to class B and A (1.3 ± 0.4) and controls (1.3* I ) (P value < 0.05). The left ventricular end diastolic volumes were increased in 3 cirrhotic patients(5.9+/_ 0.3)(normal 3.5-4.7 cm). The estimated ejection fraction was decreased in39 cirrhotic patients; 28 patients with ascites (35 -47%) as compared to 11 patients without ascites (40-48%) and controls (50-75%) (P < 0.05). Conclusion: Liver cirrhosis is associated with enlarged left cardiac chambers, but wall thickness and right ventricle functions and diameters are normal. LV Diastolic dysfunction and decreased ejection fraction are evident in cirrhotic patients with ascites in class C children. This demonstration of diastolic dysfunction together with the dilated left cardiac chambers suggests that the patients indeed have cardiac abnormalities. Cardiovascular status should therefore be carefully monitored, especially in class C children when patients have ascites.