Karabulut Aziz, Iltumur Kenan, Yalcin Kendal, Toprak Nizamettin
Department of Cardiology, Division of Hepatology, University of Dicle, Diyarbakir, Turkey.
Echocardiography. 2006 Apr;23(4):271-8. doi: 10.1111/j.1540-8175.2006.00210.x.
Liver functions are affected in the course of cardiac diseases, and similarly, liver diseases affect cardiac functions. Many studies in the literature have shown that left ventricular systolic and/or diastolic dysfunction may develop during chronic liver disease. However, there are limited studies investigating right ventricular functions during chronic liver diseases.
A total of 84 patients who had no systolic and/or diastolic dysfunction in the left ventricle (LV) were evaluated; 46 patients with liver cirrhosis; 10 (21.74%) cirrhotic patients with hepatopulmonary syndrome (HPS) (group 1), 36 (78.26) cirrhotic patients without HPS (group 2), and 38 healthy individuals were treated as control.
Right ventricular diastolic dysfunction was determined in all patients of group 1 (100%), 26 of group 2 (72.22 %), and 4 of the controls (10.52%) (P<0.05). Tricuspid deceleration time (dt) was significantly different between the groups (P<0.05). In addition, right atrium (RA) diameters, right ventricle (RV) diameters, and RV wall thickness were significantly different between the groups (P<0.05). Pulmonary artery pressure (P<0.05) and pulmonary vascular resistance (P<0.05) were also seen to be higher in group 1 than those in group 2 and control group.
Right ventricular diastolic dysfunction rate is high in chronic liver diseases. In the presence of HPS, right ventricular diastolic dysfunction is more remarkable in patients than those without HPS. Right ventricular diastolic dysfunction may result in dilatation and hypertrophy in the right heart.
肝脏功能在心脏疾病过程中会受到影响，同样，肝脏疾病也会影响心脏功能。文献中的许多研究表明，慢性肝病期间可能会出现左心室收缩和/或舒张功能障碍。然而，关于慢性肝病期间右心室功能的研究有限。
对总共84例左心室无收缩和/或舒张功能障碍的患者进行评估；46例肝硬化患者；10例（21.74%）患有肝肺综合征（HPS）的肝硬化患者（第1组），36例（78.26%）无HPS的肝硬化患者（第2组），以及38名健康个体作为对照。
第1组所有患者（100%）、第2组26例患者（72.22%）以及4例对照者（10.52%）均检测到右心室舒张功能障碍（P<0.05）。各组间三尖瓣减速时间（dt）有显著差异（P<0.05）。此外，各组间右心房（RA）直径、右心室（RV）直径和RV壁厚度也有显著差异（P<0.05）。第1组的肺动脉压（P<0.05）和肺血管阻力（P<0.05）也高于第2组和对照组。
慢性肝病患者右心室舒张功能障碍发生率较高。在存在HPS的情况下，患者的右心室舒张功能障碍比无HPS的患者更显著。右心室舒张功能障碍可能导致右心扩张和肥厚。
