Assessment of left ventricular systolic function and synchronicity in patients with different degrees of cirrhosis by real-time three-dimensional echocardiography

doi:10.3877/cma.j.issn.1672-6448.2016.01.011

Abstract

Abstract:

Objective

To quantitatively assess the left ventricular systolic dysfunction and synchronicity in patients with different degrees of cirrhosis by real-time three-dimensional echocardiography.

Methods

Collecting 50 cirrhotic patients who were divided into Child A, B and C classes and 30 healthy subjects whose age, sex and weight matched with cirrhotic patients. Ultrasonography was performed to obtain the conventional ultrasonic parameters (LAAPD, IVST, LVPWT, LVEDD, LVESD, LVEF), and three-dimensional moving images. Qlab software was used to obtain the 17-segmental volume-time curves and left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), ejection fraction (LVEF). The standard deviation and the maximal difference of the time to the point with minimal systolic volume of 16, 12, 6 segments. The above quantitative parameters were corrected by heart rate.

Results

Between cirrhosis and control group, there were statistical differences of heart rate, Systolic arterial pressure, Diastolic arterial pressure and pulse pressure (t=-5.635, 4.208, 2.183, -2.308, all P<0.05). LAAPD by 2DE in patients with cirrhosis was larger than control group, while IVST was thicker (t=-6.918, -2.940, both P<0.05). The RT-3DE quantitative parameters (T_msv16-SD, T_msv12-SD, T_msv6-SD, T_msv16-Dif, T_msv12-Dif, T_msv6-Dif, T_msv16-SD%, T_msv12-SD%, T_msv6-SD%, T_msv16-Dif%, T_msv12-Dif%, T_msv6-Dif?%, LVEDV, LVESV) have statistically differences between the two groups (t=-2.408, -3.142, -2.788, -2.761, -2.610, -2.507, -3.125, -3.725, -3.593, -2.384, -3.763, -3.657, -4.291, -4.388, all P<0.05). Comparing different cirrhosis subgroup with control group, the RT-3DE quantitative parameters (T_msv16-SD, T_msv12-SD, T_msv6-SD, T_msv16-Dif, T_msv12-Dif, T_msv6-Dif, T_msv16-SD%, T_msv12-SD%, T_msv6-SD%, T_msv16-Dif%, T_msv12-Dif%, T_msv6-Dif%, LVEDV, LVESV, LVEF) have statistically differences (F=7.563, 12.544, 7.482, 5.211, 7.197, 5.131, 6.232, 11.327, 7.233, 4.296, 8.906, 8.563, 10.904, 9.809, 0.382, all P<0.05). With the aggravation of cirrhosis, LVEF showed the decreasing tendency, while the other RT-3DE parameters (T_msv16-SD, T_msv12-SD, T_msv6-SD, T_msv16-Dif, T_msv12-Dif, T_msv6-Dif, T_msv16-SD%, T_msv12-SD%, T_msv6-SD%, T_msv16-Dif%, T_msv12-Dif%, T_msv6-Dif%, LVEDV, LVESV) showed the tendency of increasing.

Conclusions

The left ventricular systolic synchrony and part of the myocardial systolic function in patients with cirrhosis was damaged. The condition was aggravated with the degree of cirrhosis. RT-3DE can objectively evaluate left ventricular dysfunction in patients with different degrees of cirrhosis.

Key words: Echocardiography, Three-dimensional, Cirrhosis, Ventricular function, left, Synchrony

He Chang, Chunmei Jia, Kun Xu, Jian Wang, Yuxue Xu, Xiaofang Liu. Assessment of left ventricular systolic function and synchronicity in patients with different degrees of cirrhosis by real-time three-dimensional echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(01): 39-44.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.01.011

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Figures/Tables 7

References 16

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指标	异常程度记分
指标	1分	2分	3分
肝性脑病（期）	无	Ⅰ~Ⅱ	Ⅲ~Ⅳ
腹水	无	轻度（易消退）	中度以上（难消退）
血清胆红素（μmol/L）	<34	34~51	>51
血清白蛋白（g/L）	>35	28~35	<28
凝血酶原时间（s）	≤14	15~17	≥18

指标	异常程度记分
指标	1分	2分	3分
肝性脑病（期）	无	Ⅰ~Ⅱ	Ⅲ~Ⅳ
腹水	无	轻度（易消退）	中度以上（难消退）
血清胆红素（μmol/L）	<34	34~51	>51
血清白蛋白（g/L）	>35	28~35	<28
凝血酶原时间（s）	≤14	15~17	≥18

指标	正常对照组	肝硬化组	t值	P值
性别（男/女）	17/13	31/19	-	-
年龄（岁）	49.87±8.87	53.88±9.97	-1.697	>0.05
身高（cm）	165.97±6.91	167.04±7.92	-0.615	>0.05
体重（kg）	63.07±7.95	65.04±9.65	-1.061	>0.05
体重指数（kg/m²）	23.16±7.21	23.32±8.13	1.005	>0.05
心率（次/分）	66.77±6.21	77.04±10.09	-5.635	<0.05
收缩期动脉压（mmHg）	126.43±8.78	118.06±8.52	4.208	<0.05
舒张期动脉压（mmHg）	77.23±6.75	73.86±6.66	2.183	<0.05
脉压（mmHg）	49.21±6.21	44.20±6.75	-2.380	<0.05

指标	正常对照组	肝硬化组	t值	P值
性别（男/女）	17/13	31/19	-	-
年龄（岁）	49.87±8.87	53.88±9.97	-1.697	>0.05
身高（cm）	165.97±6.91	167.04±7.92	-0.615	>0.05
体重（kg）	63.07±7.95	65.04±9.65	-1.061	>0.05
体重指数（kg/m²）	23.16±7.21	23.32±8.13	1.005	>0.05
心率（次/分）	66.77±6.21	77.04±10.09	-5.635	<0.05
收缩期动脉压（mmHg）	126.43±8.78	118.06±8.52	4.208	<0.05
舒张期动脉压（mmHg）	77.23±6.75	73.86±6.66	2.183	<0.05
脉压（mmHg）	49.21±6.21	44.20±6.75	-2.380	<0.05

组别	例数	LVEDD（cm）	LVESD（cm）	LVEF（%）	LAAPD（cm）	IVST（cm）	LVPWT（cm）
健康对照组	30	4.24±0.63	2.21±0.33	67.59±7.27	3.17±0.22	0.80±0.11	0.78±0.10
肝硬化组	50	4.38±0.80	2.31±0.33	65.04±7.67	3.65±0.41	0.88±0.13	0.84±0.12
t值	?	-1.405	-0.184	1.468	-6.918	-2.940	-1.405
P值	?	>0.05	>0.05	>0.05	<0.05	<0.05	>0.05

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