TITLE:
Cirrhotic cardiomyopathy among patients with liver cirrhosis
AUTHORS:
Tilahun Belay, Todd Gress, Rameez Sayyed
KEYWORDS:
Cirrhosis; Cardiomyopathy
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.3 No.8,
December
26,
2013
ABSTRACT: Introduction: Cirrhotic cardiomyopathy (CCM) is a
clinical syndrome in patients with liver cirrhosis characterized by an abnormal and blunted response in cardiac
output and contractility to physiologic, pathologic, or pharmacologic stress
but a normal to increased cardiac response at rest [1-4]. Information on the
epidemiology and natural history of CCM is limited. Methods: All
patients with a diagnosis of cirrhosis (N = 451) seen at gastroenterology
clinic over the four years were evaluated. CCM was defined using echocardiogram
(ECHO) and electrocardiogram (ECG) criteria [1]. Patients with structural or
ischemic heart disease or incomplete information were excluded (N = 220). Results: Among the 231 patients with cirrhosis,
118 (51.1%) met criteria for CCM, and no patient had this problem documented in
their medical record. Those with CCM were older (62.7 vs 57.8 years; p age (OR 1.6 per quartile; 95% CI 1.2-2.0).
Patients with alcoholic and unknown causes of cirrhosis are more likely to have
CCM, (p CCM, a diagnosis of exclusion, defined by ECHO and ECG criteria is
a common problem among cirrhotic patients attending a gastroenterology
practice. Advancing age and female gender were associated with a higher
prevalence of CCM, but the cause of cirrhosis was not possibly limited by
smaller sample size within cause-specific categories.
CCM was not recognized by our clinicians, and routine screening tests
were not performed. Provider awareness of CCM is needed since implementation of
angiotensin receptor blocker and beta-blocker therapy early in the course of
cirrhosis may modify the changes in cardiac function [5,6].