Liver Biochemical Profiles in Congestive Heart Failure

Sankar, C (2007) Liver Biochemical Profiles in Congestive Heart Failure. Masters thesis, Madras Medical College, Chennai.

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Abstract

Abnormal liver enzymes and liver function in congestive cardiac failure has long been recognized and occurs quite frequently in acute and chronic failure. The present study was undertaken to identify alterations in the liver biochemical profiles in relation to congestive heart failure and also to show their significance with respect to the duration of heart failure. Sixty cases with heart failure of various aetiologies and twenty healthy controls were included in the study. In the present study, number of male cases were higher than number of female cases. Among sixty total cases 36 male and 24 female cases were present. Higher number of cases were found within the age group of 40 to 50 years followed by the age group of 50 to 60 years. The present study revealed rheumatic heart disease is still the leading cause of heart failure in our set up. Among the total heart failure cases, 40% were due to rheumatic heart disease. Dilated cardiomyopathies represent about 23% of cases. Heart failure secondary to coronary artery heart disease is seen in about 13% of cases. We have found five cases with acute heart failure and three cases with hypotension. Present study revealed a strong correlation between liver function derangements and the above cases. Serum bilirubin, serum aminotransferases, serum alkaline phosphatase, serum proteins, serum albumin and prothrombin time were the liver biochemical tests used in the study. Echocardiography and ultrasonography of the liver were also done in all cases. Present study has found a strong relationship between liver function derangements and heart failure cases. The study observed 20% of cases with jaundice. Among sixty cases liver enlargement was seen in 63% of cases. Increased liver size is strongly correlated with hyperbilirubinemia. Though the conjugated fraction of bilirubin is also elevated, the levels of unconjugated fraction were higher. Serum aminotransferases were elevated in 78% of cases unlike serum alkaline phosphatase which is increased only in 25% of cases. There found to be a significant correlation between rise in unconjugated bilirubin and elevation of serum aminotransferases. Study revealed marked alterations in liver function with acute heart failure and during hypotension when compared to chronic heart failure. Low serum proteins and serum albumin levels are seen in many of the cases. Various factors play in causing these changes which have already been discussed. Serum prothrombin time, though prolonged in 88% of cases, the changes were only mild.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Liver Biochemical Profiles ; Congestive Heart Failure.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 28 Mar 2018 03:43
Last Modified: 30 Mar 2018 16:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/6650

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