Background: Age-related changes in the cardiovascular system occur
in parallel with age-related changes elsewhere in the body. The interac-
tion among disease, age and lifestyle requires careful analysis when in-
terpreting a patient's complaints and altered functional capacity.
In cirrhotic patients, there are many cardiac abnormalities; early in cir-
rhosis, systolic performance parameters are increased while advanced
cirrhosis is associated with L.V. diastolic dysfunction and increase in
wall thickness.
The aim of this work was to study the altered integrated response of
the heart to liver cirrhosis in older patients.
Methods: Thirty two cirrhotic patients and twenty six healthy subjects
were evaluated by echocardiography (M-mode. 2D and Doppler Study) to
assess the differential responses of aged hearts and young hearts to liver
cirrhosis.
Results: This study had revealed a highly significant increase in EF in
cirrhotic patients which becomes more evident in early stages of liver dis-
ease. There is also a significant increase in LV wall thickness and disor-
dered diastolic junction which are more marked in advanced stages of cir-
rhosis when compared to the control group.
In the younger group of patients, there is a highly significant improve-
ment in systolic performance parameters (EF & %FS), a highly significant
increase in LV wall thickness and a highly significant deterioration of LV
diastolic junction parameters, when compared to the younger group of
control. On the other hand, older group of patients showed a highly significant
deterioration in LV diastolic filling indices but non-significant changes of
systolic performance parameters and wall thickness when compared to
the control group.
Conclusion: The age-related changes in the heart and peripheral vas-
culature alter considerably the cardiac integrated response to liver cirrho-
sis. While there was a significant improvement ofLV systolic performance
parameters in younger patients with liver cirrhosis when compared to
matched age control subgroup, this is not the case of older patients in
whom systolic performance improvement is absent. There was also a sig-
nificant increase of LV wall thickness in the younger group of cirrhotic pa-
tients but not in the older group of patients when compared to age-
matched control groups. Our study had showed a highly significant LV di-
astolic dysfunction in both age subgroups of cirrhotic patients when com-
pared to age-matched subgroups of control. This means that advanced
age of the patients can aggravate the deleterious effect of liver cirrhosis
on LV diastolic function and vice versa. |
