Author(s): Gaurav Sudhir Padia1, Devpriya Lakra2, Rajiv Lochan Khare3
Cardiovascular dysfunction is the major component of morbidity in patients of liver cirrhosis and a cardinal prognostic indicator in patients undergoing liver transplantation. The constellation of hyperdynamic circulation, peripheral vasodilation and volume overload alters the systolic and diastolic dysfunction leading to cirrhotic cardiomyopathy (CCM). In this study, we evaluated and compared the diastolic dysfunction among alcoholic and non-alcoholic cirrhotic patients.
AIMS 1) To Study the Prevalence of Diastolic Dysfunction in Alcoholic & Non-Alcoholic Cirrhotics and Controls. 2) To Compare the Diastolic functional status between alcoholic and non-alcoholic cirrhosis patients.
MATERIALS AND METHODS
A cross-sectional case control study was conducted in 100 male cirrhotic patients consisting of alcoholic and non-alcoholic cirrhotic subjects with age matched 50 controls in Pt. JNM Medical College & Dr. BRAM Hospital, Raipur. Left ventricular diastolic dysfunction was assessed using echocardiographic parameters.
The range, median, standard deviation and statistical significance were calculated. Most of the data is analysed by Student T-test, Mann Whitney U test, while the data with frequency distribution is analysed by Fisher’s exact. With p value < 0.05, the correlation was significant.
Among all cirrhotics, 49% had diastolic dysfunction (DD) in comparison to 22% controls which was statistically significant (p<0.05). 50% of the alcohol cirrhotic had DD compared with 25% of controls which was significant (p<0.05) & 46% non-alcoholic cirrhosis patients had DD compared with 26% in the control group which was statistically significant (p<0.05). 50% of alcoholic cirrhotics had DD compared with 29 (46%) non-alcoholic cirrhotic patients which was not statistically significant (p>1).
Our study showed that patients with alcoholic and non-alcoholic cirrhosis have higher occurrence of DD (49% and 46% respectively) than controls owing to alterations in the myocardial contractile and relaxation function. It also shows that although DD is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There were no significant differences in diastolic parameters between alcoholic and non-alcoholic cirrhosis concluding that alcohol likely plays a non-significant role in cardiovascular dysfunction in cirrhotics.