Karaciğer sirozlu olgularımızda sirotik kardiyomiyopatiyle ilgili belirli biyokimyasal ve ekokardiyografik parametrelerin değerlendirilmesi / Evaluation of certain biochemical and echocardiographic parameters related to cirrhotic cardiomyopathy in liver cirrhosis cases
AdvisorPROF. DR. AHMET DANALIOĞLU
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Introduction and objective: Liver cirrhosis is one of the most important causes of death in many regions around the globe and in our country. Cirrhotic patients are known to have cardiac function disorders, systolic/diastolic dysfunction and electrophysiological abnormalities. In our study, we investigated the relationship between some echocardiographic and biochemical parameters related to cirrhotic cardiomyopathy in patients with liver cirrhosis.Material and method: Between August 2009 and May 2011, 44 patients with liver cirrhosis (24 male and 20 female) attending to outpatient clinics of internal medicine and gastroenterology and control group of 30 subjects (16 male and 14 female) were enrolled in the study. The participants were evaluated with electrocardiography (ECG), echocardiography, Pro-BNP and other biochemical markers. Results were statistically analyzed with SPSS (SP-SPSS version 16).Results: Based on Child-Pugh classification, 24 of the 44 liver cirrhosis patients (54.5%) were Child-Pugh stage C. In 25 cases (56.8%) etiology of cirrhosis was HBV. Pro-BNP was 156.41±153.56 pg/ml in the patient group and 25.71±30.11 pg/ml in the control group (p < 0.001). On the ECG, QTc was 0.40 ± 0.03 sec in the cirrhotic patients and 0.38 ± 0.03 sec in the control group (p: 0.016). Among echocardiographic parameters left atrium diastolic diameter was 3.98±0.54 in the patient group and 3.46±0.45 in the control group (p < 0.001). Right ventricule tissue doppler revealed myocardial performance index as 0.27±0.05 in the patient group and 0.23±0.06 in the control group (p: 0.01). MPI calculated from septal values was 0.41±0.09 in patients and 0.36±0.07 in the controls (p: 0.02). However, left ventricular MPI values calculated by conventional methods were similar, E/A and EDZ values were not significantly different. E/E? value was 10±3 in the patients and 8±2 in the control group (p? 0.05).Conclusion: Echocardiographic parameters measured through conventional methods were not different from those of normal subjects in patients with liver cirrhosis except left atrium diameters. However, of the tissue Doppler echocardiograhpic parameters, IVS MPI, RV MPI and EE? values were disordered in patients with liver cirrhosis. Additionally, QTc was longer in cirrhotic patients than controls. ProBNP value is also higher in cirrhosis. We think that all of these findings may be related to cirrhotic cardiomyopathy.