High Rate of Cardiac Abnormalities in a Postmortem Analysis of Patients Suffering From Liver Cirrhosis. Issue 10 (November 2015)

• Record Type: Journal Article
• Authors: Wehmeyer, Malte H.; Heuer, Anika J.; Benten, Daniel; Püschel, Klaus; Sydow, Karsten; Lohse, Ansgar W.; Lüth, Stefan
• Is Part Of: Journal of clinical gastroenterology. Volume 49:Issue 10(2015)
• Publication Date: 2015-11
• Subjects: cirrhotic cardiomyopathy -- NASH -- nonalcoholic steatohepatitis -- autopsy study -- macroscopic; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000323
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Background: Cirrhotic cardiomyopathy is a recently defined cardiac disorder in patients with end-stage liver disease. The frequency and exact manifestations of cardiac changes in liver cirrhosis is unknown. Goals: We aim to describe cardiac changes in a large autopsy study of patients with liver cirrhosis. Study: Postmortem data from 895 individuals with liver cirrhosis of different origin autopsied from 1995 to 2010 were analyzed. A total of 236 patients were excluded, mostly due to an advanced age above 70 years. The remaining 659 patients were assigned to 4 subgroups according to the etiology of cirrhosis: alcoholic cirrhosis (57.4%), nonalcoholic steatohepatitis (4.2%), viral hepatitis (9.3%), and cryptogenic cirrhosis (29.1%). Predefined clinical and cardiac parameters were assessed in these groups and compared by univariate and multivariate analyses to an age-matched and sex-matched control group including 40 deceased patients without evidence of chronic liver disease. Results: A critical heart weight (24%, P =0.024), hypertrophy of the right ventricle (24%, P <0.001), and dilatation of the right ventricle (36%, P =0.040) were significantly more frequent in the cirrhosis group compared with noncirrhotic controls. Cirrhosis patients had a greater risk for high-grade coronary sclerosis (30%, P =0.019). The etiology of cirrhosis was independently associated with hypertrophy and dilatation of the right ventricle, with nonalcoholic steatohepatitis patients being at the highest risk. Conclusion: Our results demonstrate a high rate of right-ventricular abnormalities and coronary sclerosis in individuals suffering from liver cirrhosis regardless of the etiology of cirrhosis. Abstract : Supplemental Digital Content is available in the text.