Wang Li-Kun, An Xiao-Fei, Wu Xue-Liang, Zhang Su-Mei, Yang Rui-Min, Han Chao, Yang Jie-Lin, Wang Yi-Cheng
Department of Ultrasound, The First Affiliated Hospital of Hebei North University, Zhangjiakou.
Department of Intensive Care Unit, Daqing Oilfield General Hospital, Daqing.
Medicine (Baltimore). 2018 Nov;97(48):e13302. doi: 10.1097/MD.0000000000013302.
In chronic liver diseases, cirrhosis ranks as the 14th highest death cause worldwide, developing into decompensated cirrhosis. A potential and feasible technique in assessing cardiac function is urgent. This study explores if the Doppler myocardial performance (Tei) index combined with the plasma B-type natriuretic peptide (BNP) levels can assess cardiac function in patients with decompensated cirrhosis.
A total of 140 individuals were selected in the study and were classified into 3 groups: control group (n = 40, healthy individuals), compensated cirrhosis group (n = 50), and decompensated cirrhosis group (n = 50). Plasma BNP levels, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and albumin (ALB) were identified by an enzyme-linked immunosorbent assay (ELISA). The correlation of Tei index between left ventricle (LV) and right ventricle (RV) as well as plasma BNP levels with cardiac function was assessed using a Pearson test analysis. All patients were subjected to this experiment for 1 year to analyze the relationship between Tei index and plasma BNP levels in prognosis of decompensated cirrhosis patients.
Patients with decompensated cirrhosis showed significantly elevated levels of ALT, AST, and TBIL level in contrary to a reduced ALB level. Cirrhosis patients also showed a significantly reduced ejection fraction (ET) index, but an increase in isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), Tei index, and plasma BNP levels in comparison to healthy individuals. ICT, IRT, Tei index, and plasma BNP levels were elevated in decompensated cirrhotic patients as opposed to compensated cirrhotic patients. These results indicate a positive correlation of both Tei index and plasma BNP levels with cirrhosis and its progression. Tei index and plasma BNP levels are positively associated with Child-Pugh classification and negatively correlated with both cardiac function and prognosis in patients suffering from decompensated cirrhosis.
The study provided evidence supporting the correlation of Tei index and plasma BNP levels in decompensated cirrhotic patients with cardiac function, highlighting a potential value for evaluation.
在慢性肝病中，肝硬化是全球第14大致死原因，并会发展为失代偿期肝硬化。因此，急需一种潜在且可行的评估心脏功能的技术。本研究探讨多普勒心肌性能（Tei）指数结合血浆B型利钠肽（BNP）水平能否评估失代偿期肝硬化患者的心脏功能。
本研究共选取140例个体，分为3组：对照组（n = 40，健康个体）、代偿期肝硬化组（n = 50）和失代偿期肝硬化组（n = 50）。采用酶联免疫吸附测定（ELISA）法检测血浆BNP水平、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）和白蛋白（ALB）。采用Pearson检验分析左心室（LV）和右心室（RV）的Tei指数以及血浆BNP水平与心脏功能的相关性。所有患者接受本实验1年，以分析Tei指数和血浆BNP水平在失代偿期肝硬化患者预后中的关系。
失代偿期肝硬化患者的ALT、AST和TBIL水平显著升高，而ALB水平降低。与健康个体相比，肝硬化患者的射血分数（ET）指数也显著降低，但等容收缩时间（ICT）、等容舒张时间（IRT）、Tei指数和血浆BNP水平升高。与代偿期肝硬化患者相比，失代偿期肝硬化患者的ICT、IRT、Tei指数和血浆BNP水平升高。这些结果表明Tei指数和血浆BNP水平与肝硬化及其进展呈正相关。Tei指数和血浆BNP水平与Child-Pugh分级呈正相关，与失代偿期肝硬化患者的心脏功能和预后呈负相关。
本研究提供了证据支持失代偿期肝硬化患者的Tei指数和血浆BNP水平与心脏功能的相关性，突出了其潜在的评估价值。
