Cao Yang, Zhang Huihui, Li Shuai, Li Siliang, Sun Shuowen, Chen Jinwen, Ye Ting, Zhang Xijun, Yuan Jianjun
Department of Ultrasound, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.
Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou, China.
Front Cardiovasc Med. 2023 Mar 8;10:1126590. doi: 10.3389/fcvm.2023.1126590. eCollection 2023.
Liver cirrhosis is closely associated with cardiac dysfunction. The aims of this study were to evaluate left ventricular systolic function in patients with hepatitis B cirrhosis by non-invasive left ventricular pressure-strain loop (LVPSL) technique, and to explore the correlation between myocardial work indices and liver function classification.
According to the Child-Pugh classification, 90 patients with hepatitis B cirrhosis were further divided into three groups: Child-Pugh A group ( = 32), Child-Pugh B group ( = 31), and Child-Pugh C group ( = 27). During the same period, 30 healthy volunteers were recruited as the control (CON) group. Myocardial work parameters, which included global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were derived from the LVPSL and compared among the four groups. The correlation between myocardial work parameters and Child-Pugh liver function classification was evaluated, and the independent risk factors affecting left ventricular myocardial work in patients with cirrhosis were investigated by univariable and multivariable linear regression analysis.
GWI, GCW and GWE of Child-Pugh B and C groups were lower than those of CON group, while GWW was higher than that of CON group, and the changes were more obvious in Child-Pugh C group ( < 0.05). Correlation analysis revealed that GWI, GCW, and GWE were negatively correlated with liver function classification to various degrees ( = -0.54, -0.57, and -0.83, respectively, all < 0.001), while GWW was positively correlated with liver function classification ( = 0.76, < 0.001). Multivariable linear regression analysis showed that GWE was positively correlated with ALB ( = 0.17, < 0.001), and negatively correlated with GLS ( = -0.24, < 0.001).
The changes in the left ventricular systolic function in patients with hepatitis B cirrhosis were identified using non-invasive LVPSL technology, and myocardial work parameters are significantly correlated with liver function classification. This technique may provide a new method for the evaluation of cardiac function in patients with cirrhosis.
肝硬化与心脏功能障碍密切相关。本研究旨在通过无创左心室压力-应变环（LVPSL）技术评估乙型肝炎肝硬化患者的左心室收缩功能，并探讨心肌做功指标与肝功能分级之间的相关性。
根据Child-Pugh分级，将90例乙型肝炎肝硬化患者进一步分为三组：Child-Pugh A组（n = 32）、Child-Pugh B组（n = 31）和Child-Pugh C组（n = 27）。同期招募30名健康志愿者作为对照组（CON组）。从LVPSL中得出心肌做功参数，包括整体做功指数（GWI）、整体建设性做功（GCW）、整体无用功（GWW）和整体做功效率（GWE），并在四组之间进行比较。评估心肌做功参数与Child-Pugh肝功能分级之间的相关性，并通过单变量和多变量线性回归分析研究影响肝硬化患者左心室心肌做功的独立危险因素。
Child-Pugh B组和C组的GWI、GCW和GWE低于CON组，而GWW高于CON组，且在Child-Pugh C组变化更明显（P < 0.05）。相关性分析显示GWI、GCW和GWE与肝功能分级在不同程度上呈负相关（分别为r = -0.54、-0.57和-0.83，均P < 0.001），而GWW与肝功能分级呈正相关（r = 0.76，P < 0.001）。多变量线性回归分析显示GWE与白蛋白（ALB）呈正相关（r = 0.17，P < 0.001），与左心室纵向应变（GLS）呈负相关（r = -0.24，P < 0.001）。
采用无创LVPSL技术确定了乙型肝炎肝硬化患者左心室收缩功能的变化，且心肌做功参数与肝功能分级显著相关。该技术可能为评估肝硬化患者的心功能提供一种新方法。
