title: High Rate of Cardiac Abnormalities in a Postmortem Analysis of Patients Suffering From Liver Cirrhosis.
abstract: BACKGROUND
  Cirrhotic cardiomyopathy is a recently defined cardiac disorder in patients with end-stage liver disease. The frequency and exact manifestations of cardiac changes in liver cirrhosis is unknown.
  
  
  OBJECTIVE
  We aim to describe cardiac changes in a large autopsy study of patients with liver cirrhosis.
  
  
  METHODS
  Postmortem data from 895 individuals with liver cirrhosis of different origin autopsied from 1995 to 2010 were analyzed. A total of 236 patients were excluded, mostly due to an advanced age above 70 years. The remaining 659 patients were assigned to 4 subgroups according to the etiology of cirrhosis: alcoholic cirrhosis (57.4%), nonalcoholic steatohepatitis (4.2%), viral hepatitis (9.3%), and cryptogenic cirrhosis (29.1%). Predefined clinical and cardiac parameters were assessed in these groups and compared by univariate and multivariate analyses to an age-matched and sex-matched control group including 40 deceased patients without evidence of chronic liver disease.
  
  
  RESULTS
  A critical heart weight (24%, P=0.024), hypertrophy of the right ventricle (24%, P<0.001), and dilatation of the right ventricle (36%, P=0.040) were significantly more frequent in the cirrhosis group compared with noncirrhotic controls. Cirrhosis patients had a greater risk for high-grade coronary sclerosis (30%, P=0.019). The etiology of cirrhosis was independently associated with hypertrophy and dilatation of the right ventricle, with nonalcoholic steatohepatitis patients being at the highest risk.
  
  
  CONCLUSIONS
  Our results demonstrate a high rate of right-ventricular abnormalities and coronary sclerosis in individuals suffering from liver cirrhosis regardless of the etiology of cirrhosis.
authors: Departments of *Medicine †Legal Medicine, University Medical Center Hamburg-Eppendorf ‡Department of General and Interventional Cardiology, Hamburg University Heart Center, Hamburg, Germany.
authors: Malte H
authors: MH
authors: Wehmeyer
authors: Anika J
authors: AJ
authors: Heuer
authors: Daniel
authors: D
authors: Benten
authors: Klaus
authors: K
authors: Püschel
authors: Karsten
authors: K
authors: Sydow
authors: Ansgar W
authors: AW
authors: Lohse
authors: Stefan
authors: S
authors: Lüth
mesh_terms: D000368:Aged; D001344:Autopsy; D016022:Case-Control Studies; D003331:Coronary Vessels / Q000473:pathology*; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000209:etiology / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009929:Organ Size; D012598:Sclerosis / Q000209:etiology