Cardiac dysfunction in patients of cirrhosis of the liver and its correlation with Child-Pugh score: A cross-sectional study at a tertiary care center in Northern India
Bibliographic record
Abstract
Introduction: Chronic liver disease is the destruction and regeneration process of the liver parenchyma. Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyperdynamic circulation, cirrhotic cardiomyopathy (CCM), and pulmonary vascular abnormalities. CCM was first defined in 2005 at the Montreal World Congress of Gastroenterology. It is considered a condition of latent heart failure that manifests only under stress, resulting in a blunted increase in cardiac output during exercise. Methods: A total of 100 cases as per the diagnostic criteria of liver cirrhosis were enrolled from the Department of General Medicine of PGIMS, Rohtak. The assessment of cardiac function was done in all the patients. Two-dimensional echocardiogram was done to find evidence of cardiomyopathy and electrocardiogram (ECG) was done to find QT-interval prolongation. Child Turcotte Pugh (CTP) score was calculated for severity. The cardiac dysfunction was compared to the seriousness of the CTP score. Results: In our study, 57% of patients showed diastolic dysfunction while systolic dysfunction was not seen in any case. Furthermore, 56% of the cases had prolonged QTc interval in ECG. Our study also shows that there is a definitive association between QTc prolongation and disease severity. Conclusion: CCM is considered an important predictor of morbidity and mortality. The left ventricular ejection fraction at rest is normal in CCM, but there is a blunted increase in cardiac index and cardiac output during exercise. This is difficult to identify because these symptoms are similar to fatigue and exercise intolerance commonly seen in cirrhotic patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".