Cirrhotic cardiomyopathy is a constellation of structural and functional cardiac abnormalities in patients with liver cirrhosis, apart from any underlying cardiac pathology, which potentially worsens the prognosis of these patients. The objectives of this study were to describe electrocardiographic and echocardiographic abnormalities in cirrhotic patients and estimate the prevalence of cirrhotic cardiomyopathy. This is a cross-sectional study with prospective data collection, carried out in hepato-gastroenterology department of the Campus University Teaching hospital of Lomé between July and December 2019, in adult patients hospitalized for liver cirrhosis. Of the 32 patients (men: 62.5%, mean age: 53.3 ± 13.5 years), the main causes of cirrhosis were viral hepatitis (40.6%) and alcoholic cirrhosis (25 %). Cirrhosis was classified Child-Pugh C in 62.5% of patients. The most common electrocardiographic abnormalities were prolonged QTc (59.4%), sinus tachycardia (31,2%), left atrial hypertrophy (25%) and left ventricular hypertrophy (12.5%). The main echocardiographic abnormalities were high cardiac output (68.8%) and left ventricular diastolic dysfunction (56.3%). The diagnostic criteria for cirrhotic cardiomyopathy were met in 37.5% of cases and it was more frequent in Child-Pugh C patients (66.7%) and in cirrhosis of alcoholic etiology (33.4%). Whatever the etiology of cirrhosis, electrocardiographic and echocardiographic abnormalities were common. The prevalence of cirrhotic cardiomyopathy was high, hence the need for systematic cardiological assessment in these patients.
| Published in | Cardiology and Cardiovascular Research (Volume 7, Issue 4) |
| DOI | 10.11648/j.ccr.20230704.13 |
| Page(s) | 82-87 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Liver Cirrhosis, Electrocardiographic and Echocardiographic Abnormalities, Cirrhotic Cardiomyopathy
| [1] | Lee SS. Cardiac abnormalities in liver cirrhosis. West J Med. 1989; 151 (5): 530. |
| [2] | Netgen. La cardiomyopathie cirrhotique. [Internet]. Rev Med Suisse 2009; 5: 1725-31. |
| [3] | Moller S, Henriksen JH. Cardiovascular complications of cirrhosis. Postgrad Med J 2009; 85: 44-54. |
| [4] | Abelmann WH. Hyperdynamic circulation in cirrhosis: A historical perspective. Hepatology 1994; 20 (5): 1356-8. |
| [5] | Liu H, Gaskari SA, Lee SS. Cardiac and vascular changes in cirrhosis: Pathogenic mechanisms. World J Gastroenterol 2006; 12: 837-42. |
| [6] | Regan TJ, Levinson GE, Oldewurtel HA, Frank MJ, Weisse AB, Moschos CB: Ventricular function in noncardiacs with alcoholic fatty liver: role of ethanol in the production of cardiomyopathy. J Clin Invest 1969, 48: 397-407. |
| [7] | Gould L, Shariff M, Zahir M, Di Lieto M. Cardiac hemodynamics in alcoholic patients with chronic liver disease and a presystolic gallop. J Clin Invest. mai 1969; 48 (5): 860-8. |
| [8] | Limas CJ, Guiha NH, Lekagul O, Cohn JN. Impaired left ventricular function in alcoholic cirrhosis with ascites. Ineffectiveness of ouabain. Circulation. avr 1974; 49 (4): 754-60. |
| [9] | Bayley TJ, Segel N, Bishop JM. The circulatory changes in patients with cirrhosis at rest and during exercise. Clin Sci 1964; 26: 227-35. |
| [10] | Zard EM, Abbate A, Zardi DM, Dobrina A, Margiotta D, Van Tassell BW et al.— Cirrhotic Cardiomyopathy. J Am Coll Cardiol, 2010, 56, 539-49. |
| [11] | Grose RD, Nolan J, Dillon JF, Errington M, Hannan WJ, Bouchier IA, et al. Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis. J Hepatol. mars 1995; 22 (3): 326-32. |
| [12] | Finucci G, Desideri A, Sacerdoti D, Bolognesi M, Merkel C, Angeli P, et al. Left ventricular diastolic function in liver cirrhosis. Scand J Gastroenterol. mars 1996; 31 (3): 279-84. |
| [13] | Pozzi M, Carugo S, Boari G, Pecci V, de Ceglia S, Maggiolini S, et al. Evidence of functional and structural cardiac abnormalities in cirrhotic patients with and without ascites. Hepatol Baltim Md. nov 1997; 26 (5): 1131-7. |
| [14] | Wong F, Liu P, Lilly L, Bomzon A, Blendis L. Role of cardiac structural and functional abnormalities in the pathogenesis of hyperdynamic circulation and renal sodium retention in cirrhosis. Clin Sci Lond Engl 1979. sept 1999; 97 (3): 259-67. |
| [15] | Wong F, Girgrah N, Graba J, Allidina Y, Liu P, Blendis L. The cardiac response to exercise in cirrhosis. Gut. août 2001; 49 (2): 268-75. |
| [16] | Guèye MN, Louise BM, Malick B, Salamata D, Aïssé TM, Ambdil H, et al. Anomalies électrocardiographiques et échocardiographiques au cours de la cirrhose virale b: à propos de 60 cas au service d’hepato-gastroenterologie de l’Hopital Aristide Le Dantec de Dakar (HALD). Pan Afr Med J 25 juin 2018; 30: 169. |
| [17] | Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. |
| [18] | Luo S, Michler K, Johnston P, Macfarlane PW: A comparison of commonly used QT correction formulae: The effect of heart rate on the QTc of normal ECGs. J Electrocardiol, 2004; 37 (Suppl.): 81–90. |
| [19] | Główczyńska R, Galas M, Ołdakowska-Jedynak U, Peller M, Tomaniak M, Raszeja-Wyszomirska J, et al. Pretransplant QT Interval: The Relationship with Severity and Etiology of Liver Disease and Prognostic Value After Liver Transplantation. In: Annals of transplantation. 2018. |
| [20] | Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc. |
| [21] | Fouad Y, Yehia R. Hepato-cardiac disorders. World J Hepatol. 2014; 6: 41-54. |
| [22] | Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, Dokainish H, Edvardsen T, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016; 29: 277-314. Echocardiogr 2015; 28 (1): 1-39. e14. |
| [23] | Fedorak, Richard & Sherman, Philip. World Congress of Gastroenterology Canadian Bid 2005. Canadian Journal of Gastroenterology. 14. 838-840. 10. 1155/2000/284742. |
| [24] | Genovesi S, Prata Pizzala DM, Pozzi M. QT interval prolongation and decreased heart rate variability in cirrhotic patients: Relevance of hepatic venous pressure gradient and serum calcium. Clinical Science 2009: 116: 851-9. |
| [25] | Tint D, Radoi M, Coman F, Zayarache C, Rosca E. Les atteintes cardiaques dans la cirrhose hépatique-Corré1ations avec l’étiologie. Rev Med Interne. 2002; 23 (Suppl5): 523-713. |
| [26] | Møller S, Henriksen JH. Cirrhotic cardiomyopathy: a pathophysiological review of circulatory dysfunction in liver disease. Heart Br Card Soc. 2002; 87 (1): 9-15. |
| [27] | Torregrosa M, Aguadé S, Dos L, Segura R, Gónzalez A, Evangelista A, et al. Cardiac alterations in cirrhosis: reversibility after liver transplantation. J Hepatol. 2005; 42 (1): 68-74. |
| [28] | Mandell MS, Tsou MY. Cardiovascular dysfunction in patients with endstage liver disease. J Chin Med Assoc 2008; 71: 331–5. |
| [29] | Kim MY, Baik SK, Won CS. Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis. Korean J Hepatol. 2010; 16 (4): 376-382. |
| [30] | Baik SK, Fouad TR, Lee SS. Cirrhotic cardiomyopathy. Orphanet J Rare Dis. 2007; 2: 15. |
| [31] | Krag A, Bendtsen F, Mortensen C, Henriksen JH, Moller S. Effects of a single terlipressin administration on cardiac function and perfusion in cirrhosis. Eur J Gastroenterol Hepatol 2010; 22 (9): 1085-92. |
| [32] | Fouad TR, Abdel-Razek WM, Burak KW, Bain VG, Lee SS. Prediction of cardiac complications after liver transplantation. Transplantation 2009; 87 (5): 763-70. |
| [33] | Kazankov K, Holland-Fischer P, Andersen NH et al. Resting myocardial dysfunction in cirrhosis quantified by tissue Doppler imaging. Liver Int 2011; 31 (4): 534-40. |
| [34] | Wong F, Villamil A, Merli M et al. Prevalence of diastolic dysfunction in cirrhosis and its clinical significance. Hepatology 2011; 54 (Suppl.1): Abstract 229. |
| [35] | Friedman SL. Liver fibrosis — from bench to bedside. J Hepatol 2003; 38 (Suppl 1): S38-53. |
| [36] | Alqahtani SA, Fouad TR, Lee SS. Cirrhotic cardiomyopathy. Semin Liver Dis 2008; 28: 59-69. |
| [37] | Møller S, Henriksen JH. Cardiovascular complications of cirrhosis. Gut 2008; 57 (2): 268-78. |
| [38] | Cohen-Solal A, Beauvais F, Seghatol F, Durand F. Problèmes cardiaques du cirrhotique. Hépato-Gastro. 2003; 10 (6): 435-438. |
| [39] | Izzy MJ, Vanwagner LB. Current concepts of Cirrhotic Cardiomyopathy. Clin Liver Dis. 2021; 25 (2): 471–81. |
| [40] | Dash SC, Rajesh B, Behera SK, Sundaray NK, Patil P. Is Cirrhotic Cardiomyopathy Related to Cirrhosis Severity? Rambam Maimonides Med J 2023; 14 (1): e0001. |
| [41] | Enache I, Oswald-Mammosser M, Woehl- Jaegle ML. Cirrhotic cardiomyopathy and hepatopulmonary syndrome: prevalence and prognosis in a series of patients. Respir Med 2013; 107 (7): 1030-6. |
| [42] | Milani A, Zaccaria R, Bombardieri G, Gasbarrini A, Pola P. Cirrhotic cardiomyopathy. Dig Liver Dis 2007; 39: 507e15. |
| [43] | Shahvaran SA, Menyhart O, Csedrik L, Patai AV. Diagnosis and Prevalence of Cirrhotic Cardiomyopathy: A Systematic Review and Meta-analysis. Curr Probl Cardiol 2021; 46: 100821. |
| [44] | Saner FH, Neumann T, Canbay A, et al. High brain-natriuretic peptide level predicts cirrhotic cardiomyopathy in liver transplant patients. Transpl Int 2011; 24: 425e32. |
| [45] | Dourakis SP, Geladari E, Geladari C, Vallianou N. Cirrhotic Cardiomyopathy: The Interplay Between Liver and Cardiac Muscle. How Does the Cardiovascular System React When the Liver is Diseased? Current Cardiology Reviews. 2021; 17, 78-84. |
| [46] | Izzy M, VanWagner LB, Lin G, Altieri M, Findlay JY, Oh JK, Watt KD, Lee SS. The Cirrhotic Cardiomyopathy Consortium. Redefining Cirrhotic Cardiomyopathy for the Modern Era. Hepatology. 2020; 71 (1): 334–45. |
APA Style
Yayehd, K., Tcherou, T., Laté Lawson-Ananissoh, M., Defodji, A., Tchoua, E., et al. (2023). Electrocardiographic and Echocardiographic Abnormalities, and Cirrhotic Cardiomyopathy in Patients Hospitalized at the Campus University Hospital (Lomé). Cardiology and Cardiovascular Research, 7(4), 82-87. https://doi.org/10.11648/j.ccr.20230704.13
ACS Style
Yayehd, K.; Tcherou, T.; Laté Lawson-Ananissoh, M.; Defodji, A.; Tchoua, E., et al. Electrocardiographic and Echocardiographic Abnormalities, and Cirrhotic Cardiomyopathy in Patients Hospitalized at the Campus University Hospital (Lomé). Cardiol. Cardiovasc. Res. 2023, 7(4), 82-87. doi: 10.11648/j.ccr.20230704.13
AMA Style
Yayehd K, Tcherou T, Laté Lawson-Ananissoh M, Defodji A, Tchoua E, et al. Electrocardiographic and Echocardiographic Abnormalities, and Cirrhotic Cardiomyopathy in Patients Hospitalized at the Campus University Hospital (Lomé). Cardiol Cardiovasc Res. 2023;7(4):82-87. doi: 10.11648/j.ccr.20230704.13
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author = {Komlavi Yayehd and Tchaa Tcherou and Mawuli Laté Lawson-Ananissoh and Agossou Defodji and Eyana Tchoua and Soulemane Pessinaba and Wiyaou Dieudoné Kaziga and Soodogoua Baragou and Aklesso Bagny and Findibe Damorou},
title = {Electrocardiographic and Echocardiographic Abnormalities, and Cirrhotic Cardiomyopathy in Patients Hospitalized at the Campus University Hospital (Lomé)},
journal = {Cardiology and Cardiovascular Research},
volume = {7},
number = {4},
pages = {82-87},
doi = {10.11648/j.ccr.20230704.13},
url = {https://doi.org/10.11648/j.ccr.20230704.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20230704.13},
abstract = {Cirrhotic cardiomyopathy is a constellation of structural and functional cardiac abnormalities in patients with liver cirrhosis, apart from any underlying cardiac pathology, which potentially worsens the prognosis of these patients. The objectives of this study were to describe electrocardiographic and echocardiographic abnormalities in cirrhotic patients and estimate the prevalence of cirrhotic cardiomyopathy. This is a cross-sectional study with prospective data collection, carried out in hepato-gastroenterology department of the Campus University Teaching hospital of Lomé between July and December 2019, in adult patients hospitalized for liver cirrhosis. Of the 32 patients (men: 62.5%, mean age: 53.3 ± 13.5 years), the main causes of cirrhosis were viral hepatitis (40.6%) and alcoholic cirrhosis (25 %). Cirrhosis was classified Child-Pugh C in 62.5% of patients. The most common electrocardiographic abnormalities were prolonged QTc (59.4%), sinus tachycardia (31,2%), left atrial hypertrophy (25%) and left ventricular hypertrophy (12.5%). The main echocardiographic abnormalities were high cardiac output (68.8%) and left ventricular diastolic dysfunction (56.3%). The diagnostic criteria for cirrhotic cardiomyopathy were met in 37.5% of cases and it was more frequent in Child-Pugh C patients (66.7%) and in cirrhosis of alcoholic etiology (33.4%). Whatever the etiology of cirrhosis, electrocardiographic and echocardiographic abnormalities were common. The prevalence of cirrhotic cardiomyopathy was high, hence the need for systematic cardiological assessment in these patients.
},
year = {2023}
}
TY - JOUR T1 - Electrocardiographic and Echocardiographic Abnormalities, and Cirrhotic Cardiomyopathy in Patients Hospitalized at the Campus University Hospital (Lomé) AU - Komlavi Yayehd AU - Tchaa Tcherou AU - Mawuli Laté Lawson-Ananissoh AU - Agossou Defodji AU - Eyana Tchoua AU - Soulemane Pessinaba AU - Wiyaou Dieudoné Kaziga AU - Soodogoua Baragou AU - Aklesso Bagny AU - Findibe Damorou Y1 - 2023/11/09 PY - 2023 N1 - https://doi.org/10.11648/j.ccr.20230704.13 DO - 10.11648/j.ccr.20230704.13 T2 - Cardiology and Cardiovascular Research JF - Cardiology and Cardiovascular Research JO - Cardiology and Cardiovascular Research SP - 82 EP - 87 PB - Science Publishing Group SN - 2578-8914 UR - https://doi.org/10.11648/j.ccr.20230704.13 AB - Cirrhotic cardiomyopathy is a constellation of structural and functional cardiac abnormalities in patients with liver cirrhosis, apart from any underlying cardiac pathology, which potentially worsens the prognosis of these patients. The objectives of this study were to describe electrocardiographic and echocardiographic abnormalities in cirrhotic patients and estimate the prevalence of cirrhotic cardiomyopathy. This is a cross-sectional study with prospective data collection, carried out in hepato-gastroenterology department of the Campus University Teaching hospital of Lomé between July and December 2019, in adult patients hospitalized for liver cirrhosis. Of the 32 patients (men: 62.5%, mean age: 53.3 ± 13.5 years), the main causes of cirrhosis were viral hepatitis (40.6%) and alcoholic cirrhosis (25 %). Cirrhosis was classified Child-Pugh C in 62.5% of patients. The most common electrocardiographic abnormalities were prolonged QTc (59.4%), sinus tachycardia (31,2%), left atrial hypertrophy (25%) and left ventricular hypertrophy (12.5%). The main echocardiographic abnormalities were high cardiac output (68.8%) and left ventricular diastolic dysfunction (56.3%). The diagnostic criteria for cirrhotic cardiomyopathy were met in 37.5% of cases and it was more frequent in Child-Pugh C patients (66.7%) and in cirrhosis of alcoholic etiology (33.4%). Whatever the etiology of cirrhosis, electrocardiographic and echocardiographic abnormalities were common. The prevalence of cirrhotic cardiomyopathy was high, hence the need for systematic cardiological assessment in these patients. VL - 7 IS - 4 ER -
Department of Cardiology, Faculty of Health Sciences, University of Lomé, Lomé, Togo
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