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终末期肝病严重程度对心脏结构和功能的影响。

Impact of the severity of end-stage liver disease in cardiac structure and function.

机构信息

Heart Institute, University of Sao Paulo School of Medicine, Brazil.

出版信息

Ann Hepatol. 2013 Jan-Feb;12(1):85-91.

Abstract

BACKGROUND

The impact of end-stage liver disease (ESLD) in cardiac remodeling of patients with cirrhosis is unknown. Our aim was to correlate the severity of ESLD with morphologic and functional heart changes.

MATERIAL AND METHODS

184 patients underwent a protocol providing data on the severity of ESLD and undergoing echocardiography to assess the diameters of the left atrium and right ventricle; the systolic and diastolic diameters of the left ventricle, interventricular septum, and posterior wall of the left ventricle; systolic pulmonary artery pressure; ejection fraction; and diastolic function. Severity of ESLD was assessed by the Model for End-Stage Liver Disease (MELD) score.

RESULTS

Left-atrial diameter (r = 0.323; IC 95% 0.190-0.455; p < 0.001), left-ventricular diastolic diameter (r = 0.177; IC 95% 0.033-0.320; p = 0.01) and systolic pulmonary artery pressure (r = 0.185; IC 95% 0.036-0.335; p = 0.02) significantly correlated with MELD score. Patients with MELD ≥ 16 had significantly higher left-atrial diameter and systolic pulmonary artery pressure, compared with patients with MELD scores < 16 points.

CONCLUSIONS

Changes in cardiac structure and function correlate with the severity of ESLD.

摘要

背景

终末期肝病(ESLD)对肝硬化患者心脏重构的影响尚不清楚。我们的目的是探讨 ESLD 的严重程度与心脏形态和功能变化之间的相关性。

材料与方法

184 例患者接受了一项方案,该方案提供了 ESLD 严重程度的数据,并进行了超声心动图检查,以评估左心房和右心室的直径;左心室、室间隔和左心室后壁的收缩和舒张直径;肺动脉收缩压;射血分数;和舒张功能。ESLD 的严重程度通过终末期肝病模型(MELD)评分进行评估。

结果

左心房直径(r = 0.323;IC 95% 0.190-0.455;p < 0.001)、左心室舒张直径(r = 0.177;IC 95% 0.033-0.320;p = 0.01)和肺动脉收缩压(r = 0.185;IC 95% 0.036-0.335;p = 0.02)与 MELD 评分显著相关。MELD≥16 分的患者左心房直径和肺动脉收缩压明显高于 MELD 评分<16 分的患者。

结论

心脏结构和功能的变化与 ESLD 的严重程度相关。

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