A Study on Liver Function Abnormalities in Congestive Cardiac Failure in Government General Hospital, Siddipet
Authors/Creators
- 1. Assistant Professor, Department of General Medicine, Govt. General Hospital, Siddipet, Telangana
- 2. Junior Resident, Department of Dental Surgery, Govt. General Hospital, Siddipet, Telangana
- 3. Assistant Professor, Department of Dental Surgery, Govt. General Hospital, Siddipet, Telangana
- 4. Professor & Head of the Department of General Medicine, Govt. General Hospital, Siddipet, Telangana
Description
Aim of the Study: To study the liver function tests in congestive cardiac failure and the relationship between liver function test and remission and exacerbation of congestive cardiac failure. Material and Methods: All cases of congestive cardiac failure (100), of varied etiologies observed in patients from July 2020 to December 2021. This study is an observational study, comparing the liver functions between cases (various causes of heart failure) and between cases and controls. Results: 24 patients with rheumatic heart disease,17 patients showed abnormal liver function (72%), Of the 18 patients with cor pulmonale 12 showed abnormal liver function (69%). In 6 patients with hypertensive heart disease 3 showed abnormal liver function (57%), whereas in 38 patients with coronary artery heart disease, 27 showed abnormal liver function (73%) 10 out of 14 patients with cardiomyopathy showed abnormal liver function. Conclusion: Liver function abnormalities were mostly present in patients with coronary artery disease (73%) and rheumatic valvular heart disease (70%) developing heart failure.
Abstract (English)
Aim of the Study: To study the liver function tests in congestive cardiac failure and the relationship between liver function test and remission and exacerbation of congestive cardiac failure. Material and Methods: All cases of congestive cardiac failure (100), of varied etiologies observed in patients from July 2020 to December 2021. This study is an observational study, comparing the liver functions between cases (various causes of heart failure) and between cases and controls. Results: 24 patients with rheumatic heart disease,17 patients showed abnormal liver function (72%), Of the 18 patients with cor pulmonale 12 showed abnormal liver function (69%). In 6 patients with hypertensive heart disease 3 showed abnormal liver function (57%), whereas in 38 patients with coronary artery heart disease, 27 showed abnormal liver function (73%) 10 out of 14 patients with cardiomyopathy showed abnormal liver function. Conclusion: Liver function abnormalities were mostly present in patients with coronary artery disease (73%) and rheumatic valvular heart disease (70%) developing heart failure.
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IJTPR,Vol13,Issue8,Article22.pdf
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Additional details
Dates
- Accepted
-
2023-07-30
Software
References
- 1. The commonest aetiology of cases presenting with features of congestive cardiac failure at Government General Hospital, Siddipet is coronary artery heart disease. 2. Liver function abnormalities were mostly present in patients with coronary artery disease (73%) and rheumatic valvular heart disease (70%) developing heart failure. 3. Liver function abnormalities were least in patient with hypertensive heart disease (50%) developing heart failure. 4. The serum bilirubin, serum alkaline phosphatase and serum transaminases returned to normal with remission. Serum protein values and the prothrombin time did not change with remission. 5. The serum bilirubin, serum enzymes and prothrombin time were elevated with exacerbation. Serum proteins did not show any change with exacerbation. 6. Severe congestive cardiac failure with hypotension leads to a gross elevation of serum asparate transaminase and alanine transaminase. 7. Serum alkaline phosphatase elevation correlated with the presence of hepatomegaly. 8. Serum bilirubin levels at presentation of more than 5mg, presence of hypoalbuminemia and albumin-globulin ratio reversal were associated with a poor prognosis. References 1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ. Heart disease and stroke statistics-2015 update a report from the american heart association. Circulation. 2015; 131: e29-e322. 2. Ambrosy AP, Dunn TP, Heidenreich PA. Effect of minor liver function test abnormalities and values within the normal range on survival in heart failure. Am J Cardiol. 2015; 115: 938-941. 3. Samsky MD, Patel CB, DeWald TA, Smith AD, Felker GM, Rogers JG, Hernandez AF. Cardiohepatic interactions in heart failure: an overview and clinical implications. J Am Coll Cardiol. 2013; 61: 2397-2405. 4. Van Deursen VM, Edwards C, Cotter G, Davison BA, Damman K, Teerlink JR, Metra M, Felker GM, Ponikowski P, Unemori E, Severin T, Voors AA. Liver function, in-hospital, and post-discharge clinical outcome in patients with acute heart failure-results from the relaxin for the treatment of patients with acute heart failure study. J Card Fail. 2014; 20: 407- 413. 5. Heidenreich PA, Albert NM, Allen LA, et al. forecasting the impact of heart failure in the United States: a policy statement from the American heart association. Circ Heart Fail. 2013; 6:606-19. 6. Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham heart study. Circulation. Hospitalization and mortality rates for Medicare beneficiaries, 1998-2008. JAMA 7. Chen J. Normand S-LT, Wang Y, et al. National and regional trends in heart failure 8. CANTAROW, A.: Studies of hepatic function in poital cirrhosis and congestive heart failure. Arch. Int. M\led. 56: 521: 1935. 9. Harrison's principle of medicine, 15th edition. Braunwald et al. 20. Harrisons principle of medicine, 17th edition table 227 -1. Harrison's principle of medicine 13th edition. 998-1000. 10. Robertson, W. E., Swahm, W. A., And Konzelmann, F. W.: Functional capacity of the liver; comparative merits of five most popular tests. 11. Ottenberg, R.: Jaundice in heart failure, Libman Anniv. Volume 3, New York, Robbins pathological basis disease, structural and functional unit of liver acinus, 6:212 12. Mallory, F. B.: Chronic passive congestion of the liver, J. Med. esidents 24: 455, 1911 Lambert, R. A., and Allison, B. R.: 1Pathological changes in the liver in chronic passive congestion. Proc. N. Y. Path. Soc. 16: 33, 1916 13. BLOORi, AV. R.: The (letermination of cholesterol in b) lood. J. Biol. Chemi. 29: 437, 1917. 14. White T J; Leevy CM; Brusea AM; Grasi AM. The liver in congestive cardiac failure. American journal 1955;49;250-7 15. Sinha, Mathur watri, Congestive hepatomegaly Gastroenterology 1960 16. Dunn G D, Hayes P, Breen KJ, et al. The liver in congestive heart failure a review. American journal of medical science. 1973, 265 174-189 17. Richman SM; Delman AJ, Alterations in indices of liver functions in congestive heart failure in reference to serum enzymes, American journal Med 1961; 30 211-225. 18. Gravin, C. F.: Cardiac cirrhosis. Am. J. M. Sc. 205: 515, 1943. 19. Herxheimer, CT.: Zur Pathologie der Gitterfasern der Leber, zugleich ein Beitrag zui Frage der sog. Stauungsciirrhose. Beitr. z. path. Anat. u. allg. Path. 43: 284. 20. Kubo SH, Walter BA, John DHA, Clark M and Cody J, Liver function abnormalities in chronic heart failure, influence of systemic hemodynamics. 21. Zieve J Lab, Clinical medicine 1951 22. SHEILA SHERLOCK. Diseases of liver and biliary system – eleventh edition –p 1-16. 23. Felder L, Mund A, Parker JG, Liver functions in chronic congestive cardiac failure, Circulation Vol, 9:11 286; 1950 24. Novel O, Henrion J, Bernau J, Degott C, Rueff B and Benhamou JP, Digestive disease diseases and sciences. 1980; 25, 49- 52.