Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
Hepatology Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
Eur J Intern Med. 2015 Dec;26(10):830-4. doi: 10.1016/j.ejim.2015.10.009. Epub 2015 Oct 29.
Cirrhotic cardiomyopathy has been characterized by impaired contractile response to stress and/or altered diastolic relaxation, with electrophysiological abnormalities in the absence of known cardiac disease. However, the clinical significance of diastolic dysfunction (DDF) in cirrhotic patients has not been clarified.
We studied 84 cirrhotic patients with normal systolic function to evaluate the prevalence of DDF using tissue Doppler imaging, and to investigate the possible correlation of DDF with outcomes (hospitalization, death) and with the specific causes of death.
The mean follow-up was 10±8months. DDF was diagnosed in 22 patients (26.2%). Patients with DDF more frequently had ascites (90.9% vs. 64.5 %; p=0.026), lower levels of albumin (OR: 5.39; p=0.004), higher NT-proBNP levels, and longer QTc interval (464±23ms vs. 452±30ms; p=0.039). At follow-up, patients with DDF did not have a higher incidence of adverse events in terms of hospitalization and death.
The presence of diastolic dysfunction has not been found to be clearly associated with outcome, and prognosis has been determined primarily by the severity of liver disease.
肝硬化性心肌病的特征是收缩期对压力的反应受损和/或舒张期松弛改变，存在电生理异常而无已知的心脏疾病。然而，肝硬化患者舒张功能障碍（DDF）的临床意义尚未阐明。
我们研究了 84 例收缩功能正常的肝硬化患者，使用组织多普勒成像评估 DDF 的患病率，并探讨 DDF 与结局（住院、死亡）和特定死亡原因的可能相关性。
平均随访时间为 10±8 个月。22 例（26.2%）患者诊断为 DDF。DDF 患者更常出现腹水（90.9% vs. 64.5%；p=0.026）、白蛋白水平较低（OR：5.39；p=0.004）、较高的 NT-proBNP 水平和更长的 QTc 间期（464±23ms vs. 452±30ms；p=0.039）。在随访期间，DDF 患者的住院和死亡不良事件发生率没有更高。
舒张功能障碍的存在与结局无明显相关性，预后主要取决于肝病的严重程度。
