TO STUDY THE INCIDENCE OF PULMONARY HYPERTENSION IN PATIENTS OF CHRONIC LIVER DISEASE

Dr. Rajat Jain, Dr. Zaki Siddiqui, Gauri Naryani, Swati Azad, Sanya Jain

Abstract


Background

Cirrhosis and portal hypertension have been found to be associated with pulmonary hypertension and pulmonary dysfunction. Several clinical studies have demonstrated 20% higher prevalence of pulmonary hypertension in patients with advanced liver disease and portal hypertension. There has been increasing recognition of the importance of these pulmonary vascular complications of liver disease, with increasing realization that these complications influence survival before, during and after liver transplantation.

Aim of the Study

The primary objective of our study was to check for the prevalence of pulmonary hypertension in the patients of chronic liver disease by transthoracic echocardiography, presenting  with or without symptoms suggestive of  cardio-vascular involvement.

The secondary objective of this study was to plan for further study to see the effects of available drugs for pulmonary hypertension on patients with pulmonary hypertension with chronic liver disease and the use of presence of pulmonary hypertension as one of the criteria for referral to liver transplantation.

Material and Methods

This study was conducted in medicine department of MLB medical college, Jhansi from May 2018 to May 2019. 90 patients of chronic liver disease were taken as subjects and 75 age and sex matched patients without CLD were taken as controls.  Based upon their symptoms, the subjects were divided into 2 groups:Group A – patients of CLD presenting with symptoms suggestive of CV involvement and Group B – patients of CLD presenting without symptoms suggestive of CV involvement

Observation:

In our study, there were 72 male patients (42 in group A, 30 in group B) and 18 female patients (12 in group A and 6 in group B). Majority of the patients were above 40 years of age (60 out of total 90 patients). The cause of CLD in majority of the subjects (50%) was chronic alcoholism, in 30% it was chronic hepatitis-B  while 20% had other causes. 40% of our subjects were found to have pulmonary hypertension, 44.44% of all the patients of group A and 33.33% of all patients of group B.

 Conclusion

There is high incidence of pulmonary hypertension in patients of CLD and alcohol addiction is the most common cause of CLD in Bundelkhand region. Trans-thoracic echocardiography is a simple and non-invasive technique for diagnosis of pulmonary hypertension.


 

Keywords


Portal hypertension, pulmonary hypertension, echocardiography

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References


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