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慢性肝病患者心血管异常的评估:一项横断面研究。

The Assessment of Cardiovascular Abnormalities in Patients With Chronic Liver Disease: A Cross-Sectional Study.

作者信息

Shah Kunjan PareshKumar, Kuruvada Sailaja, Gopalakrishnan Mridulkrishnan, Latchireddy Bhargavi, Prathima Talla, Patra Niyati

机构信息

Department of General Medicine, Dr. N.D. Desai Faculty of Medical Science and Research, Nadiad, IND.

Department of General Medicine, University College London, London, GBR.

出版信息

Cureus. 2024 Nov 9;16(11):e73311. doi: 10.7759/cureus.73311. eCollection 2024 Nov.

Abstract

Background Chronic liver disease (CLD) is associated with a wide range of systemic complications, including cardiovascular abnormalities. This study aimed to assess the prevalence of cardiac abnormalities and to correlate with the severity of liver disorder. Materials and methods A cross-sectional analysis comprising 120 adult subjects diagnosed with CLD was performed. Data were collected through clinical assessments, including liver function tests, echocardiography, and electrocardiograms (ECG). The severity of CLD was determined using the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scoring systems. Results In this study, 85 (70.8%) were men, and the major cause of CLD was alcoholism in 89 (66.7%) of the patients. Regarding CLD severity, the majority of patients were in MELD stage 2, and 70 (58.3%) and 76 (63.3%) were in CTP class C. The prevalence of various cardiac abnormalities was as follows: left ventricular systolic dysfunction (LVSD) in 25 (20.8%), left ventricular diastolic dysfunction (LVDD) in 76 (63.3%), and prolonged corrected QT (QTc) in 52 (43.3%) of the CLD patients. The values of the QTc interval were higher in MELD stage 3, and it was significant (p=0.001). The association between LVSD (p=0.004) and LVDD (p=0.001) was significant, and the proportion of CLD subjects with cardiac dysfunction was greater in CTP class C compared to classes B and A. Conclusion The present study highlights a concerning prevalence of cardiovascular abnormalities among chronic liver disease patients, underscoring the need for routine cardiovascular assessment in this population.

摘要

背景 慢性肝病(CLD)与多种全身并发症相关,包括心血管异常。本研究旨在评估心脏异常的患病率,并与肝脏疾病的严重程度相关联。材料与方法 对120名被诊断为CLD的成年受试者进行了横断面分析。通过临床评估收集数据,包括肝功能检查、超声心动图和心电图(ECG)。使用Child-Turcotte-Pugh(CTP)和终末期肝病模型(MELD)评分系统确定CLD的严重程度。结果 在本研究中,85名(70.8%)为男性,CLD的主要病因是酗酒,89名(66.7%)患者如此。关于CLD严重程度,大多数患者处于MELD 2期,70名(58.3%)和76名(63.3%)处于CTP C级。各种心脏异常的患病率如下:25名(20.8%)CLD患者存在左心室收缩功能障碍(LVSD),76名(63.3%)存在左心室舒张功能障碍(LVDD),52名(43.3%)存在校正QT(QTc)延长。QTc间期值在MELD 3期更高,且具有显著性(p = 0.001)。LVSD(p = 0.004)和LVDD(p = 0.001)之间的关联具有显著性,与B级和A级相比,CTP C级CLD受试者中心脏功能障碍的比例更高。结论 本研究突出了慢性肝病患者中心血管异常令人担忧的患病率,强调了对该人群进行常规心血管评估的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22dd/11626255/9e65efe99b9d/cureus-0016-00000073311-i01.jpg

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