Anomalies électrocardiographiques et échocardiographiques au cours de la cirrhose virale b: à propos de 60 cas au service d’hepato-gastroenterologie de l’Hopital Aristide Le Dantec de Dakar (HALD)

2018 
: This study aimed to evaluate the electrocardiographic abnormalities in patients with cirrhosis due to viral hepatitis B and to identify their determinants. We conducted a prospective study in the Hepatogastroenterologic Department and in the Department of Cardiology at the Aristide Le Dantec Hospital in Dakar over a period of 8 months. All patients with cirrhosis due to viral hepatitis B and without a history of heart disease were included in the study. We collected and analyzed the epidemiological, clinical, echographic, endoscopic, electrocardiographic, echocardiographic (2D and Doppler) data and laboratory data from all patients. Sixty patients were enrolled. The prevalence of cirrhosis due to viral hepatitis B was 3.4%. The average age was 41 years and the sex-ratio was 1.6 (37 men). Cirrhosis was classified as Child-Pugh B in 29 patients (49%), Child-Pugh C and Child Pugh A in 20 patients (33%) and 11 patients (18%) respectively. The most common electrocardiographic abnormalities included left ventricular hypertrophy and QTc interval prolongation detected in 27 patients (45%) and 24 patients (40%) respectively. Statistical analysis showed an association between prolonged QTc interval and the severity of cirrhosis (p = 0.01, RR = 2, CI = 0.24 - 0.341). Echocardiographic abnormalities were dominated by left ventricle dilatation (58.3%) and cardiac hyperoutput (43.3%), with an average output of 6.05 l/ min. Statistical analysis revealed a significant association between cirrhosis severity and cardiac hyperoutput (p = 0.003; CI: 95%, 2,883-38,58; RR = 2). A total of 14 patients (23.3%) had latent cirrhotic cardiomyopathy. Cirrhosis due to viral hepatitis B can cause a wide range of different cardiac abnormalities. These include morphological and/or electrophysiological abnormalities whose severity appears to be correlated with cirrhosis severity.
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