Cardiac damage in liver cirrhosis in alcohol abusers


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Abstract

Aim. To estimate the contribution of liver cirrhosis (LC) to the development of heart diseases in alcohol abusers. Subjects and methods. The investigation included 80 patients with alcoholic LC without a history of cardiovascular and respiratory diseases and, as a control group, 32 alcohol abusers without a history of chronic diseases of the liver and cardiovascular and respiratory systems; 45 patients with alcoholic cardiomyopathy (ACM) and congestive heart failure without a history of coronary heart disease and valvular diseases, among whom 11 patients were found to have LC. In addition to standard clinical examination, all the patients underwent electrocardiography, by estimating the corrected QT interval (QTc), standard echocardiography; and those without ACM underwent estimation of left ventricular (LV) kinetics using speckle-tracking echocardiography. Results. The patients with alcoholic LC were found to have a higher LV ejection fraction and a more obvious impairment of LV global longitudinal deformity, and more commonly LV diastolic dysfunction. 16 of the 80 patients with LC were observed to have moderate pulmonary hypertension while the mean pulmonary artery pressure (MPAP) was within the normal range in all the patients without LC. A prolonged QTc interval was revealed in the patients with LC. The duration of QTc was directly correlated with the MELD severity of LC. The patients with chronic heart failure in the presence of ACM and CL showed a more obvious LV diastolic dysfunction, as estimated by E/E’, a greater LV mass index, and a higher MPAP than those with ACM without LC. Conclusion. The LC patients both with ACM and without a history of diseases of the heart were noted to have its more evident disorders as diastolic dysfunction and elevated MPAP. Those without ACM were observed to have impaired LV global deformity and a prolonged QTc interval.

References

  1. Klatsky A. Alcohol and cardiovascular diseases: where do we stand today? JIntern Med. 2015;278(3):238-250. doi: 10.1111/joim.12390
  2. Jepsen P, Ott P, Andersen PK, Sшrensen HT, Vilstrup H. The clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study. Hepatology. 2010;51:1675-1682. doi: 10.1002/hep.23500
  3. Kowalski H, Abelmann WH. The cardiac output at rest in Laennec’s cirrhosis. J Clin Invest. 1953;32:1025-1033.
  4. Ingles AC, Hernandez I, Garcia-Estan J, Quesada T, Carbonell LF. Limited cardiac preload reserve in conscious cirrhotic rats. Am J Physiol. 1991;260:H1912-H1917.
  5. Caramelo C, Fernandez-Munoz D, Santos JC, Blanchart A, Rodriguez-Puyol D, Lo´pez-Novoa JM, et al. Effect of volume expansion on hemodynamics, capillary permeability and renal function in conscious, cirrhotic rats. Hepatology. 1986;6:129-134. doi: 10.1002/hep.1840060125
  6. Castro A, Jimenez W, Claria J, Ros J, Martinez JM, Bosch M, et al. Impaired responsiveness to angiotensin-II in experimental cirrhosis: role of nitric oxide. Hepatology. 1993;18:367-372. doi: 10.1016/0270-9139(93)90020-n
  7. Polio J, Sieber CC, Lerner E, Groszmann RJ. Cardiovascular hyporesponsiveness to norepinephrine, propranolol and nitroglycerin in portal-hypertensive and aged rats. Hepatology. 1993;18:128-136. doi: 10.1016/0270-9139(93)90516-p
  8. Grose RD, Nolan J, Dillon JF, Errington M, Hannan WJ, Bouchier IAD et al. Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis. J Hepatology. 1995;22:326-332. doi: 10.1016/0168-8278(95)80286-x
  9. Moller S, Henriksen JH. Cardiovascular complications of cirrhosis. Gut. 2008;57:268-278. doi: 10.1136/gut.2006.112177
  10. Torregrosa M, Aguade S, Dos L, Segura R, Gonzalez A, Evangelista A, et al. Cardiac alterations in cirrhosis: reversibility after liver transplantation. J Hepatol. 2005;42:68-74. doi: 10.1016/j.jhep.2004.09.008
  11. Rabie RN, Cazzaniga M, Salerno F,WongF. The use of E/A ratio as a predictor of outcome in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt. Am J Gastroenterol. 2009;104:2458-2466. doi: 10.1038/ajg.2009.321
  12. Krowka MJ, Swanson KL, Frantz RP, McGoon MD, Wiesner RH. Portopulmonary hypertension: results from a 10-year screening algorithm. Hepatology. 2006;44:1502-1010. doi: 10.1002/hep.21431
  13. Wong F, Villamil A, Merli M, Romero G, Angeli P, Caraceni P, Steib CJ, Baik SK, Spinzi G, Colombato LA, Salerno F. Prevalence of diastolic dysfunction in cirrhosis and its clinical significance. Hepatology. 2011;54(Suppl 1):A475-А476.
  14. Kazankov K, Holland-Fischer P, Andersen NH, Torp P, Sloth E, Aagaard NK, Vilstrup H. Resting myocardial dysfunction in cirrhosis quantified by tissue Doppler imaging. Liver Int. 2011;31:534-540. doi: 10.1111/j.1478-3231.2011.02468.x
  15. Sun F, Wang Y, Wang B, Tong J, Zhang D, Chang, B. Relationship between model for end-stage liver disease score and left ventricular function in patients with end-stage liver disease. Hepatobiliary Pancreatic Diseases International. 2011;10(1):50-54. doi: 10.1016/s1499-3872(11)60007-6
  16. Bernardi M, Calandra S, Colantoni A, Trevisani F, Raimondo M, Sica G, Schepis F, Mandini M, Simoni P, Contin M, Raimondo G. Q—T interval prolongation in cirrhosis: Prevalence, relationship with severity, and etiology of the disease and possible pathogenetic factors. Hepatology. 1998;27(1):28-34. doi: 10.1002/hep.510270106
  17. Bai S, Fouad T, Lee S. Cirrhotic cardiomyopathy. Orphanet J Rare Dis. 2007;2(1):15. doi: 10.1186/1750-1172-2-15
  18. McDonnell P, Toye P, Hutchins G. Primary Pulmonary Hypertension and Cirrhosis: Are They Related? Am Rev Respir Dis. 1983;127(4):437-441. doi: 10.1164/arrd.1983.127.4.437
  19. Hadengue A, Benhayoun MK, Lebrec D, Benhamou JP. Pulmonary hypertension complicating portal hypertension: prevalence and relation to splanchnic hemodynamics. Gastroenterology. 1991;100:520-528.
  20. Plevak D, Krowka M, Rettke S, Dunn W, Southorn P. Successful liver transplantation in patients with mild to moderate pulmonary hypertension. Transplant Proc. 1993;25:1840.
  21. Benjaminov F, Sniderman K, Siu S, Liu P, Prentice M, Wong F. Porto-pulmonary hypertension in decompensated cirrhosis and refractory ascites. Gastroenterology. 2001;120(5):A377. doi: 10.1016/s0016-5085(08)81874-4
  22. Калачѐва Т.П., Чернявская Г.М., Белобородова Э.И. Формирование легочной гипертензии у больных циррозом печени. Бюллетень сибирской медицины. 2009;4(2):45-51.
  23. Raevens S, Colle I, Reyntjens K, Geerts A, Berrevoet F, Rogiers X, Troisi R, Van Vlierberghe H, De Pauw M. Echocardiography for the detection of portopulmonary hypertension in liver transplant candidates: An analysis of cutoff values. Liver Transpl. 2013;19(6):602-610. doi: 10.1002/lt.23649
  24. Sampaio F, Pimenta J, Bettencourt N, Fontes-Carvalho R, Silva A, Valente J, Bettencourt P, Fraga J, Gama V. Systolic and diastolic dysfunction in cirrhosis: a tissue-Doppler and speckle tracking echocardiography study. Liver Int. 2013;33(8):1158-1165. doi: 10.1111/liv.12187
  25. Nazar A, Guevara M, Sitges M, Terra C, Solà E, Guigou C, Arroyo V, Ginès P. LEFT ventricular function assessed by echocardiography in cirrhosis: Relationship to systemic hemodynamics and renal dysfunction. J Hepatol. 2013;58(1):51-57. doi: 10.1016/j.jhep.2012.08.027

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