Study of Cardiovascular Dysfunction in Cirrhosis and Its Correlation With Severity at a Tertiary Care Hospital

Background: Cirrhosis of the liver is accompanied by systemic circulatory changes that can give rise to cardiovascular changes collectively termed cirrhotic cardiomyopathy. While these changes can be clinically silent, they can aggravate conditions, especially in the later stages of liver disease. The current study aims to examine cardiovascular dysfunction in patients with cirrhosis and its relationship with disease severity. Methods: Between April 2023 and June 2024, a study was carried out at Srirama Chandra Bhanja Medical College and Hospital in Cuttack, involving 103 participants. Each patient underwent a series of evaluations, including echocardiography, laboratory tests, electrocardiography (ECG), and clinical examinations. Additionally, the Child-Turcotte-Pugh (CTP) classification was utilized to assess the severity of cirrhosis. To evaluate cardiac dysfunction, cardiology blood tests, ECG, and echocardiography were performed to measure the left ventricular ejection fraction. Results: The mean age of the study population was 44.22 ± 10.97 years (n = 103), with 66 male (64%) and 37 female (36%) participants. Alcohol-related liver disease was the most common etiology (72 patients, 69.9%). Diastolic dysfunction was the most frequent cardiac abnormality and increased significantly with worsening CTP class (p < 0.05). Systolic dysfunction was less common, with most patients demonstrating preserved ejection fraction. ECG abnormalities, including QT interval prolongation, were observed in a subset of patients. Given the predominance of alcohol-related cirrhosis, the potential independent contribution of alcohol to cardiac abnormalities should also be considered. Conclusion: Cardiovascular dysfunction, particularly diastolic dysfunction, is common in cirrhotic patients and correlates with the severity of liver disease. However, the high proportion of alcohol-related cirrhosis in the study population may have influenced the observed cardiac findings. Routine cardiovascular assessment may facilitate early detection and improved clinical management.