A PROSPECTIVE EVALUATION OF HEPATIC PARAMETERS IN CONGESTIVE HEART FAILURE PATIENTS
Keywords:heart failure, hepatomegaly, biochemical parameters
Aim: The aim of the study to find out the prevalence of liver function abnormalities in heart failure patients, pattern of elevation of liver enzymes and correlation of liver function tests with etiology, duration and of heart failure.
Material and methods: This is a prospective study was conducted in the Department of General Medicine Nalanda Medical College and Hospital, Patna, Bihar, India from October 2019 to March 2020. The hepatic biochemical parameters like serum bilirubin (direct, indirect and total), serum AST and ALT, Serum alkaline phosphatase, Serum proteins and Prothrombin time were estimated.
Results: In present study mean age of patient was 57.68±11.78 years. Maximum number of patients was from 50 to 75 years of age that is 45 (56.25%). As per NYSA classification maximum number of cases were class II (46.25%) followed by class III (26.25%). Percentage of patients with class I were 18.75% and class IV were 8.75%. Maximum number of patients has disease from to 4-year duration that is 66.25%. Regarding clinical presentation of patient’s jaundice was present in 27.5%, hepatomegaly which was most commonly present that was 47.5%, ascites was present in 28.75% and congested hepatomegaly in USG (41.25%). Regarding hepatic biochemical parameters there is significant variation in serum bilirubin (mg/dl) parameter as per progress in class of heart failure (p=0.001). Serum bilirubin was 3.88±1.57 mg/dl in class IV and least in class I that is 1.132±0.28 mg/dl. Serum AST was highest in class IV 161.14±25.85 IU and least in class I that is 35.68±11.87 IU (p=0.001). Serum ALT was highest in class IV 188.98±35.85 IU and least in class I that is 35.11±10.56 (p=0.001). Serum ALP was highest in class IV 62.27±15.32 IU and least in class I that is 39.48±8.85 (p=0.01). Serum total protein (g/dl) was decreased as the heart failure progressed least in class IV 3.59±1.47 g/dl and highest in class I that is 6.78.14±2.14 gm/dl (p=0.05). Serum albumin (g/dl) was least in class IV 2.79±0.82 g/dl and highest in class I that is 4.75±0.85 gm/dl (p=0.034). Prothrombin time (sec) was highest in class IV 23.24±6.11 sec and least in class I that is 13.12±3.36 sec (p=0.01).
Conclusion: We conclude that heart failure was common in fifth and sixth decade of life and there was male predominance. Congested hepatomegaly was common presentation jaundice and ascites was also common. Change in biochemical parameters was increased with severity and duration of heart disease.
Keywords: heart failure, hepatomegaly, biochemical parameters
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