超声心动图相关参数与失代偿期肝硬化预后的相关性：一项回顾性队列研究。
Association of echocardiography-related parameters with the prognosis of decompensated cirrhosis: a retrospective cohort study.
机构信息
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.
Postgraduate College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
出版信息
Curr Med Res Opin. 2024 Apr;40(4):613-620. doi: 10.1080/03007995.2024.2319821. Epub 2024 Mar 4.
BACKGROUND
Cardiac morphology and function, which are conventionally evaluated by echocardiography, are often abnormal in decompensated cirrhosis. We aimed to evaluate the association of echocardiography-related parameters with prognosis in cirrhosis.
METHODS
This retrospective study included 104 decompensated cirrhotic patients, in whom cardiac structure and function were measured by echocardiography, including mitral inflow early diastolic velocity/mitral inflow late diastolic velocity (E/A), left atrium diameter, left ventricular end-diastolic dimension, interventricular septal thickness, left ventricular posterior wall thickness, right atrial transverse diameter, right atrial longitudinal diameter, right ventricular dimension (RVD), stroke volume, cardiac output, left ventricular ejection fraction, and fractional shortening. Cox regression and competing risk analyses and Kaplan-Meier and Nelson-Aalen cumulative risk curves were used to evaluate their associations with further decompensation and death in cirrhotic patients, if appropriate.
RESULTS
Lower RVD was a predictor of further decompensation in Cox regression (adjusted by Child-Pugh score: = 0.138; adjusted by MELD score: = 0.034) and competing risk analyses ( = 0.003), and RVD ≤17 mm was significantly associated with higher cumulative incidence of further decompensation in Kaplan-Meier ( = 0.002) and Nelson-Aalen cumulative risk curves ( = 0.002). E/ ≤ 0.8 was a significant predictor of death in Cox regression (adjusted by Child-Pugh score: = 0.041; adjusted by MELD score: = 0.045) and competing risk analyses ( = 0.024), and E/ ≤ 0.8 was significantly associated with higher cumulative incidence of death in Kaplan-Meier ( = 0.023) and Nelson-Aalen cumulative risk curves ( = 0.024). Other echocardiography-related parameters were not significantly associated with further decompensation or death.
CONCLUSION
RVD and E/A may be considered for the prognostic assessment of decompensated cirrhosis.
背景
心脏形态和功能通常通过超声心动图评估，在失代偿性肝硬化中往往异常。我们旨在评估超声心动图相关参数与肝硬化预后的关系。
方法
这项回顾性研究纳入了 104 例失代偿性肝硬化患者，通过超声心动图测量心脏结构和功能，包括二尖瓣流入早期舒张速度/二尖瓣流入晚期舒张速度（E/A）、左心房直径、左心室舒张末期内径、室间隔厚度、左心室后壁厚度、右心房横径、右心房长径、右心室径（RVD）、心排量、心输出量、左心室射血分数和缩短分数。 Cox 回归和竞争风险分析以及 Kaplan-Meier 和 Nelson-Aalen 累积风险曲线用于评估它们与肝硬化患者进一步失代偿和死亡的关系，如果适当的话。
结果
较低的 RVD 是 Cox 回归（通过 Child-Pugh 评分调整：=0.138；通过 MELD 评分调整：=0.034）和竞争风险分析（=0.003）中进一步失代偿的预测因子，RVD≤17mm 与 Kaplan-Meier 中进一步失代偿的累积发生率显著相关（=0.002）和 Nelson-Aalen 累积风险曲线（=0.002）。E/A≤0.8 是 Cox 回归（通过 Child-Pugh 评分调整：=0.041；通过 MELD 评分调整：=0.045）和竞争风险分析（=0.024）中死亡的显著预测因子，E/A≤0.8 与 Kaplan-Meier 中死亡的累积发生率显著相关（=0.023）和 Nelson-Aalen 累积风险曲线（=0.024）。其他超声心动图相关参数与进一步失代偿或死亡无显著相关性。
结论
RVD 和 E/A 可用于评估失代偿性肝硬化的预后。
Zotero 插件