Prevalence of Cirrhotic Cardiomyopathy among Patients with Liver Cirrhosis at Kenyatta National Hospital
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Abstract
Background - Cardiac dysfunction is not uncommon in liver cirrhosis. Cirrhotic Cardiomyopathy is an impaired contractile responsiveness to stress and/or abnormal diastolic function with associated electrophysiological abnormalities in lack of other known cardiac diseases. This form of cardiac disorder bears significant morbidity and mortality particularly after invasive procedures.
Objective - Determine the Prevalence of Cirrhotic Cardiomyopathy among patients with liver Cirrhosis at Kenyatta National Hospital.
Design: This was hospital based descriptive cross-sectional study
Setting: Kenyatta National Hospital out-patient liver clinic and medical wards. Nairobi, Kenya.
Subjects: Forty-four patients with liver cirrhosis presenting to Kenyatta National Hospital.
Interventions: All patients underwent resting echocardiography and 12-lead electrocardiogram
Results: Forty-four patients were recruited. The mean age of the participants was 44 years. 27 (61.4%) were males. Hepatitis B infection (38.6%) and chronic alcohol consumption (38.6%) were the two leading etiology of liver cirrhosis. Out of 44 patients, 17 (38.6%) belonged to class A, 16 (36.4%) to class B, and 11 (25.0%) to class C. Three (6.8%) patients were found to have systolic dysfunctions. 19 (43.2%) diastolic dysfunction; more than three quarter (94.7%) of these had grade1 diastolic dysfunction. Prolonged (>440ms) QTc interval was present in 25 (56.8%) patients.
Cirrhotic cardiomyopathy was recorded in 43.2% of the study population. Liver disease severity did not show correlation with the cardiomyopathy.
Conclusion: The prevalence of cirrhotic cardiomyopathy as mainly driven by diastolic and systolic dysfunction was high in this black African population of liver cirrhosis. QTc interval prolongation was common in our study. The severity of liver disease did not show association with the presence of cirrhotic cardiomyopathy.
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