THERAPEUTIC CHALLENGES AND PROGNOSIS INFLUENCE OF CARDIOVASCULAR COMORBIDITIES IN CIRRHOTIC PATIENTS

The effects of advanced liver diseases on heart function, like cirrhotic cardiomyopathy, hepato-pulmonary syndrome or porto-pulmonary arterial hypertension, are well known today. Cardiovascular Diseases (CVD) may affect the liver or increase a pre-existed liver disease in acute or chronic heart failure. The aim of this study was to evaluate the frequency of CV comorbidities in cirrhotic patients and to establish the influence on patients’ outcome. Material and methods: The current prospective study was conducted over a 16-month period and included 105 patients diagnosed with liver cirrhosis (LC). Patients were extensively analyzed for the presence of CVD, both clinical and echo cardio graphic. Results: The main etiology of LC was viral C infection, followed by alcoholic exposure. Dilatative cardiomyopathy, high blood pressure, heart failure with reduced ejection fraction, arrhythmias and deep vein thrombosis were more prevalent in patients with viral liver disease.  The valvular diseases were more frequent diagnosed in patients with a worse prognosis (31.4% vs. 25.7%, p =0.001), though there were no difference between patients with viral or alcoholic etiology. Conclusions: Our study confirmed that there is a high prevalence of different CVD in patients with LC, mostly in patients with viral etiology, and there is a great need for standardized protocols and guidelines for the initial approach, treatment and follow-up of the CV dysfunction in LC patients.