Guèye Mamadou Ngoné, Louise Bassène Marie, Malick Bodian, Salamata Diallo, Aïssé Thioubou Mame, Ambdil Halim, Polèle Fall Marième, Bamba Cissé Cheikh Ahmadou, Daouda Dia, Mouhamadou Mbengue, Abdou Ba Serigne, Lamine Diouf Mamadou
Service d'Hépato, Gastroentérologie HALD, Senegal.
Service d'Hépato-Gastroentérologie Hôpital Général de Grand Yoff, Senegal.
Pan Afr Med J. 2018 Jun 25;30:169. doi: 10.11604/pamj.2018.30.169.12344. eCollection 2018.
This study aimed to evaluate the electrocardiographic abnormalities in patients with cirrhosis due to viral hepatitis B and to identify their determinants. We conducted a prospective study in the Hepatogastroenterologic Department and in the Department of Cardiology at the Aristide Le Dantec Hospital in Dakar over a period of 8 months. All patients with cirrhosis due to viral hepatitis B and without a history of heart disease were included in the study. We collected and analyzed the epidemiological, clinical, echographic, endoscopic, electrocardiographic, echocardiographic (2D and Doppler) data and laboratory data from all patients. Sixty patients were enrolled. The prevalence of cirrhosis due to viral hepatitis B was 3.4%. The average age was 41 years and the sex-ratio was 1.6 (37 men). Cirrhosis was classified as Child-Pugh B in 29 patients (49%), Child-Pugh C and Child Pugh A in 20 patients (33%) and 11 patients (18%) respectively. The most common electrocardiographic abnormalities included left ventricular hypertrophy and QTc interval prolongation detected in 27 patients (45%) and 24 patients (40%) respectively. Statistical analysis showed an association between prolonged QTc interval and the severity of cirrhosis (p = 0.01, RR = 2, CI = 0.24 - 0.341). Echocardiographic abnormalities were dominated by left ventricle dilatation (58.3%) and cardiac hyperoutput (43.3%), with an average output of 6.05 l/ min. Statistical analysis revealed a significant association between cirrhosis severity and cardiac hyperoutput (p = 0.003; CI: 95%, 2,883-38,58; RR = 2). A total of 14 patients (23.3%) had latent cirrhotic cardiomyopathy. Cirrhosis due to viral hepatitis B can cause a wide range of different cardiac abnormalities. These include morphological and/or electrophysiological abnormalities whose severity appears to be correlated with cirrhosis severity.
本研究旨在评估乙型病毒性肝炎肝硬化患者的心电图异常情况，并确定其决定因素。我们在达喀尔阿里斯蒂德·勒丹泰克医院的胃肠肝病科和心脏病科进行了一项为期8个月的前瞻性研究。所有乙型病毒性肝炎肝硬化且无心脏病史的患者均纳入本研究。我们收集并分析了所有患者的流行病学、临床、超声、内镜、心电图、超声心动图（二维和多普勒）数据以及实验室数据。共纳入60例患者。乙型病毒性肝炎肝硬化的患病率为3.4%。平均年龄为41岁，性别比为1.6（37名男性）。肝硬化患者中，29例（49%）为Child-Pugh B级，20例（33%）为Child-Pugh C级，11例（18%）为Child-Pugh A级。最常见的心电图异常包括左心室肥厚和QTc间期延长，分别在27例（45%）和24例（40%）患者中检测到。统计分析显示，QTc间期延长与肝硬化严重程度之间存在关联（p = 0.01，RR = 2，CI = 0.24 - 0.341）。超声心动图异常主要表现为左心室扩张（58.3%）和心输出量增加（43.3%），平均输出量为6.05升/分钟。统计分析显示，肝硬化严重程度与心输出量增加之间存在显著关联（p = 0.003；CI：95%，2.883 - 38.58；RR = 2）。共有14例患者（23.3%）存在潜在的肝硬化性心肌病。乙型病毒性肝炎肝硬化可导致多种不同的心脏异常。这些异常包括形态学和/或电生理异常，其严重程度似乎与肝硬化严重程度相关。
