Piscaglia F, Valgimigli M, Rapezzi C, Ferlito M, Gaiani S, Siringo S, Gramantieri L, Bolondi L
Division of Internal Medicine, University of Bologna, Italy.
Dig Liver Dis. 2000 Jun-Jul;32(5):392-7. doi: 10.1016/s1590-8658(00)80259-5.
Patients with alcoholic cirrhosis have left ventricular dimensions similar to controls. Few data have been reported in patients with cirrhosis of viral origin.
To assess left ventricular dimensions in patients with pure viral cirrhosis.
Thirty patients with virus-related cirrhosis, 23 patients with alcoholic cirrhosis and 12 healthy controls were submitted to measurement of left ventricular volumes, cardiac output, mean arterial pressure and total peripheral resistance.
Patients with cirrhosis showed a similar increase in cardiac index and heart rate and reduction of mean arterial pressure and peripheral vascular resistance in comparison to controls, irrespective of the aetiology. Left ventricular end systolic volume index was lower (p<0.01) and ejection fraction higher (p<0.01) in virus-related cirrhotic patients [mean +/- SD, respectively 12.4+/-4.1 ml/sqm and 77.9%) in comparison both to controls (21.5+/-6.3 ml/sqm and 66.8%) and alcoholics (20.6+/-7.0 ml/sqm and 68.8%). End diastolic volume index was not significantly different between the three groups.
Our findings indicate smaller left ventricular volumes and higher ejection fraction in pure virus-related cirrhosis than in alcoholic cirrhosis and controls. Since peripheral haemodynamics proved similar in virus- and alcohol-related cirrhosis, a subclinical alcohol cardiomyopathy may be hypothesised to account for the absence of such left ventricular pattern in alcoholic patients.
酒精性肝硬化患者的左心室大小与对照组相似。关于病毒源性肝硬化患者的数据报道较少。
评估单纯病毒相关性肝硬化患者的左心室大小。
对30例病毒相关性肝硬化患者、23例酒精性肝硬化患者和12例健康对照者进行左心室容积、心输出量、平均动脉压和总外周阻力的测量。
与对照组相比，肝硬化患者无论病因如何，其心脏指数和心率均有相似程度的升高，平均动脉压和外周血管阻力均降低。与对照组（分别为21.5±6.3 ml/平方米和66.8%）及酒精性肝硬化患者（20.6±7.0 ml/平方米和68.8%）相比，病毒相关性肝硬化患者的左心室收缩末期容积指数较低（p<0.01），射血分数较高（p<0.01）[平均值±标准差分别为12.4±4.1 ml/平方米和77.9%]。三组间舒张末期容积指数无显著差异。
我们的研究结果表明，单纯病毒相关性肝硬化患者的左心室容积较酒精性肝硬化患者和对照组小，射血分数较高。由于病毒相关性和酒精相关性肝硬化患者的外周血流动力学相似，因此可以推测亚临床酒精性心肌病可解释酒精性肝硬化患者不存在这种左心室模式的原因。
