Frequency of Echocardiographic Changes in Patients with Chronic Liver Disease at a Tertiary Care Hospital in Karachi: Echocardiographic Changes in Chronic Liver Disease

Hafiza Bazarqa; Muhammad Tanveer Alam; Syed Muhammad Kashif; Hari Lal; Beenish Imam; Sabiha Banu

doi:10.54393/pjhs.v6i12.3503

Authors

Hafiza Bazarqa Department of Medicine, Dr. Ruth K. M. Pfau, Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan
Muhammad Tanveer Alam Department of Medicine, Dr. Ruth K. M. Pfau, Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan
Syed Muhammad Kashif Department of Medicine, Dr. Ruth K. M. Pfau, Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan
Hari Lal Department of Medicine, Dr. Ruth K. M. Pfau, Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan
Beenish Imam Department of Cardiology, Dr. Ruth K. M. Pfau, Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan
Sabiha Banu Department of Medicine, Dow University Hospital, Ojha Campus, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i12.3503

Keywords:

Cirrhotic Cardiomyopathy, Echocardiography, Chronic Liver Disease, Diastolic Dysfunction, Systolic Dysfunction, Child-Pugh Classification

Abstract

Chronic liver disease (CLD) is a major health burden in Pakistan, commonly due to viral hepatitis. Cirrhotic cardiomyopathy (CCM) is an underdiagnosed complication that may impact prognosis and management. Objectives: To determine the frequency and spectrum of echocardiographic abnormalities in CLD patients and assess their correlation with disease severity based on the Child-Pugh classification. Methods: A cross-sectional study of 187 adult CLD patients was conducted at Dr. Ruth K.M. Pfau Civil Hospital, Karachi, between September 2024 and February 2025. Echocardiographic parameters, including pulmonary artery pressure, ejection fraction, systolic, and diastolic function, were evaluated using a Philips EPIQ 7 (Philips Healthcare, Andover, MA, USA) system. Patients were categorized according to Child-Pugh class (B or C). Associations between echocardiographic findings and Child-Pugh class were analyzed using chi-square and logistic regression tests, with p < 0.05 considered significant. Results: Mean age was 55.6 ± 13.4 years; 51.9 % were men. The leading etiologies were hepatitis C (46 %) and B (26 %). Diastolic dysfunction was the most frequent abnormality (53.5 %), while systolic dysfunction occurred in 23.5 %—significantly more common in women (p < 0.001) and in advanced disease (Child-Pugh C: 67 % vs B: 38 %; OR ≈ 3.4, p=0.0001). Pulmonary hypertension (23.5%) and reduced ejection fraction (10.2%) showed no correlation with Child-Pugh class. Conclusions: Echocardiographic abnormalities are common in CLD, particularly diastolic dysfunction. Systolic dysfunction increases with worsening hepatic severity, emphasizing the need for routine cardiac assessment in cirrhotic patients for better risk stratification and management.

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