Abstract

Introduction: Nonalcoholic fatty liver disease has become the most common liver disease worldwide. The prevalence of NAFLD is rising rapidly because of ongoing epidemics of obesity and type 2 diabetes. NAFLD is also an emerging problem in the Asia Pacific region, where it is likely to increase in the future. The estimated prevalence of NAFLD is currently 25% of the global adult population. The prevalence in the morbidly obese population has been estimated around 75-92%.The presence of cardiovascular dysfunction in liver cirrhosis has been described, which is usually a dilated cardiomyopathy with decreased ejection fraction. Only in the last 2 decades an increasing body of evidence shows that NAFLD has to be considered as a significant independent risk factor for cardiovascular disease. Long term follow-up studies demonstrate cardiovascular mortality to be the most important cause of death in NAFLD patients.

Aims of the Study: To study the type of cardiac dysfunction among nonalcoholic fatty liver disease patients. To study the association between cardiac dysfunction with stages of cirrhosis.

Materials and Method: It was a cross sectional study done on 40 patients admitted in medicine department of AGMC & GBP Hospital, Agartala between April.2018 to Nov.2018.

Results: Out of all patients of NAFLD 60% were females and 40% were males. So female preponderance is found in development of NAFLD. Out of all patients of NAFLD 55% were from rural areas and 45% were from urban areas. Out of all patients 40% patients had normal ecg,17.5% patients had RBBB, 12.5% had 1^st degree heart block and Bifascicular block respectively,10% had  LBBB, 7.5% had 2^nd degree heart block.Out of all patients with CTP score A had grade 1 diastolic dysfunction in 10.5% patients. Patients with CTP score B had grade 1 diastolic dysfunction in 52.6% patients, grade 2 diastolic dysfunction in 10% patients. Patients with CTP score C had grade 2 diastolic dysfunction in 90% patients. So this study shows that decompensated cirrhosis with CTP score C had more grade 2 diastolic dysfunction compare to CTP score B. Out of all patients with CTP score A had pericardial effusion in 4% patients. Patients with CTP score B had pericardial effusion in 48% patients. Patients with CTP score C had pericardial effusion in 48% patients. So this study shows that decompensated cirrhosis with CTP score B & C had more pericardial effusion compare to CTP score A.

Discussion: This study shows that females are more prone to develop Non Alcoholic Fatty Liver Disease (NAFLD), peoples from rural areas are more affected than urban areas. Chi-Square test shows strong association between CTP Score with pericardial effusion with a p value of 0.014(<0.05).Chi-Square test shows strong association between CTP Score with diastolic dysfunction with a p value of 0.001(<0.05).The study reflects that ecg and echocardiography testing should be an important component of evaluation cardiovascular dysfunction among nonalcoholic fatty liver disease. This study will help in reducing cardiovascular related morbidity and mortality among nonalcoholic fatty liver disease patients.

Abbreviations: NAFLD: Non alcoholic fatty liver disease, RBBB: Right bundle branch block, LBBB: Left bundle branch block, CTP: Child-turcotte-pugh, CVD-Cardiovascular disease.