Study Cardiac Dysfunction as an Early Predictor of Esophageal Varices in Patients with Liver Cirrhosis ‎

Abstract

Background and aim: Due to the increased mortality and danger of bleeding, the presence of esophageal varices (EV) caused by portal hypertension is a serious concern in cirrhotic patients. 60-80% of newly diagnosed cirrhotic patients have EV, and 5-15% of big EV cases experience their first variceal bleeding within the first year. Our goal was to investigate the relationship between cardiac dysfunction and endoscopic indicators of portal hypertension in cirrhotic patients.Methods: 60 participants were included; 40 cirrhotic patients with oesophageal varices and 20 non-cirrhotic individuals with no evidence of portal hypertension in endoscopy (control group). Complete blood count, liver and kidney functions, Esophagogastroduodenoscopy, Electrocardiographic evaluation, and echocardiography were performed. Results:The QTc interval, the LA volume, LV mass index, E-wave deceleration time, atrial flow velocities, E/E′ ratio, and E/A ratio were significantly increased among cirrhotic patients compared to controls. However, only the LA volume was substantially higher and E/E′ ratio was considerably lower for patients with high-grade EV than those with low grades. ROC curve to discriminate between cirrhotic and noncirrhotic groups, the QTc interval, E-wave deceleration time, and E/A ratio had the highest accuracy 93.7%, 96.1%, and 84.2% respectively.Likewise, discriminating patients with high-grade EV from those with low ones, LA volume, E/È ratio, and QTc interval showed the highest accuracy at 75.6%, 70.9%, and 66.7% respectively with the sensitivity of 92.31, 100.0, and 76.92 respectively. Conclusion: Electrocardiographic and echocardiographicexaminations are valuable non-invasive procedures that could evaluate cardiac dysfunction in cirrhotic patients and could help predict EV .

Cardiac Dysfunction and Its Relation to Degree of Esophageal Varices in Cirrhotic Patients

“…According to Seleem H. et al 2022 research, patients with high-grade EV had significantly lower E/E′ ratios and significantly higher LA volumes than those with low grades [43].…”