A Study on cardiac dysfunction in non diabetic, non hypertensive patients with liver cirrhosis

Background: Cirrhotic cardiomyopathy (CCM) represents a subclinical cardiac dysfunction observed in patients with liver cirrhosis, often unmasked only during physiological stress. Despite its clinical relevance, particularly in the context of liver transplantation, the characterization of cardiac dysfunction among cirrhotic patients devoid of conventional cardiovascular comorbidities remains limited.

Objectives: To evaluate the prevalence and patterns of cardiac dysfunction in non-diabetic, non-hypertensive patients with liver cirrhosis using electrocardiographic and echocardiographic parameters, and to explore its association with liver disease severity based on the Child-Pugh classification.

Methods: This cross-sectional study included 100 cirrhotic patients without diabetes or hypertension. Detailed clinical evaluation, ECG, and transthoracic echocardiography were conducted. Parameters such as QTc interval, ejection fraction (EF), E/A ratio, and left atrial (LA) volume were assessed. The Child-Pugh score was used to stratify liver disease severity.

Results: Cirrhotic cardiomyopathy was present in 35% of the cohort, with a significantly higher prevalence in Child-Pugh class B compared to class A. The mean QTc interval was 443.13 ± 26.87 ms. Diastolic dysfunction, as defined by an E/A ratio < 1, was seen in 35% of cases. Systolic dysfunction (EF < 60%) was found in 71% of patients. These abnormalities correlated significantly with advancing Child-Pugh class. 

Conclusion: Cardiac dysfunction in cirrhosis is a direct hepatic consequence and independent of systemic comorbidities. Routine cardiovascular evaluation in cirrhotic patients is recommended, especially to enhance pre-transplant risk stratification.