الفهرس 
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Abstract
Cirrhosis is a chronic (ongoing, long-term) disease of the liver. It means damage to the normal liver tissue that
prevents this important organ from working as it should. If the damage is not stopped, the liver gradually loses its ability to carry out its normal functions. This is called liver failure,
sometimes referred to as end-stage liver disease. Cirrhosis of he liver is disease found all over the world, affecting all races, age groups and both sexes. The clinical presentation of liver cirrhosis is often asymptomatic until complications appear. MELD score was originally used to determine the priority of
organ transplant recipients but it was later modified to estimate the
severity of end-stage liver disease in pretransplant patient, i.e.
increased MELD score was closely associated with increased mortality .Recently the MELD scoring system has been recognized as an ideal approach for evaluating end-stage liver diseaseThe heart and liver are closely interrelated, with disease processes in one affecting the function of the other. Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyper dynamic circulation, cirrhotic cardiomyopathy, and pulmonary vascular abnormalities. The pathogenic mechanisms of these cardiovascular changes are multifactorial and include neurohumoral and vascular dysregulations. Accumulating evidence suggests that cirrhosis-related cardiovascular abnormalities play a major role in the pathogenesis of multiple life-threatening complications including hepatorenal syndrome, ascites,
spontaneous bacterial peritonitis, gastro esophageal varices, and
hepatopulmonary syndrome. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically
atent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain .Abnormalities of left ventricular structure,unction and electrophysiological changes in patients with endtage liver disease
are correlated with the MELD score.
The present study was done in order to detect the echocardiographic changes in patients with HCV liver cirrhosis and
their correlation with MELD score. It was performed on 40 patients with HCV related liver cirrhosis .All patients were subjected to detailed medical history taking with special emphasis on cardiovascular symptoms, other comorbidities (DM, HTN), history
of traditional risk factors for cardiovascular diseases including.
General and local examination, were performed for all patients as well as laboratory investigations including Complete blood count,serum creatinine, serum albumin, total bilirubin, INR. Our results show that the most prevalent echocardiographic
abnormality in HCV liver cirrhosis patients is decrease E/A ratio
which also had significant negative correlation with MELD score.
So we recommend frequent echocardiographic examination
or patients with liver cirrhosis with special emphasis on E/A ratio as predictor for disease worsening and liability for cardiac complications in setting of cirrhosis. The most prevalent echocardiographic change in HCV related liver cirrhosis is decreased E/A ratio which was found in
72.5 % while other changes (increased LVPWT, IVS, LAD, EF, LVEDD, and LVESD) are less prevalent. Also E/A ratio
was found to be negatively correlated with MELD score in significant manner. Also we found variable correlation patterns betweendifferent echo parameters and liver function tests components.