Sarcouncil Journal of Medicine and Surgery

Abstract: Background: The worldwide prevalence of cirrhosis is unknown; however, it has been estimated to be between 0.15% and 0.27%. About 25,000 cases of portal hypertension occur for every 100,000 people with non-alcoholic fatty liver disease. Heart is one of the most adversely affected organs in cirrhosis and it increases morbidity and mortality in these patients. The transthoracic echocardiography is the first-line noninvasive screening tool widely available for porto-pulmonary hypertension. Golden standard for the diagnosis of porto-pulmonary hypertension is right heart catheterization. Aim of study: To evaluate the relationship between portal hypertension and echocardiographic abnormalities in patient with underlying liver cirrhosis. Patients and methods: A cross-sectional study that was conducted at Baghdad Teaching Hospital, during a period of nine months from 1st of August 2023 till 1st of May 2024. It included 50 patients diagnosed with liver cirrhosis who were either admitted to the hospital or attending the outpatient clinic of the GIT center. All patients were sent for transthoracic echocardiography with examination, measurements and calculations were done according to guidelines of American society of echocardiography. Results: In this study, 46% were found to have a portosystemic shunt. Patients with positive portosystemic shunt had significantly higher MELD scores, higher VR basil diameter, PASP, PADP, and had significantly lower RV, FAC% and TAPSE when compared to the patients with negative portosystemic shunt. MELD score was significantly higher in patients with CPS grade C compared to those with grade A and grade B. VR basil diameter, PASP, and PADP were significantly increased with increasing severity of disease, while RV FAC% was significantly decreased with increasing severity of disease. There was a positive, significant correlation between the MELD score and RV basil diameter, PASP and PADP, while there was inverse significant correlation with RV FAC% and TAPSE. Conclusion: In Portopulmonary shunt and portopulmonary hypertension are significantly associated with liver cirrhosis with the presence of portal hypertension. Patients with cirrhosis have significant cardiac dysfunction that is evident on echocardiography.