Bingol Gulsum, Avci Demir Fulya, Özden Özge, Ohtaroglu Tokdil Kardelen, Unlu Serkan, Nasıfov Muharrem, Okuyan Hızır, Boyuk Ferit, Canbolat Ismail P, Camkiran Volkan, Sarı İbrahim, Okcun Barıs, Kargı Ahmet, Polat Kamil Yalcın
Cardiology, Arel University Medical Faculty, Istanbul, TUR.
Cardiology, Memorial Bahcelievler Hospital, Istanbul, TUR.
Cureus. 2024 Dec 19;16(12):e75998. doi: 10.7759/cureus.75998. eCollection 2024 Dec.
Introduction We aimed to assess whether partial hepatectomy has an influence on conventional and speckle tracking parameters on echocardiography in living liver donors in the early postoperative period. Methods This study was a retrospective study to investigate the cardiac effects of liver donation after the transplant operation in a high-volume liver transplant center. Ninety living liver donors were included in the study. The echocardiographic images were obtained from 90 living liver donors before and five to seven days after the operation. The echocardiographic examinations were evaluated with a Philips Epiq 7 ultrasound system (Philips Ultrasound; Bothell, WA, USA) by experienced cardiologists in accordance with the recommendations of the American Society of Echocardiography. These included M-mode, two-dimensional imaging, tissue Doppler assessment at the septal and lateral mitral annulus, and strain imaging in all patients at rest in the left decubitus position. The changes in echocardiographic parameters in living liver donors were analyzed. Paired T-test was used to assess significant differences. Results The left ventricular (LV) global longitudinal strain (GLS), right ventricular (RV) GLS, and RV free wall LS, reservoir phase of left atrial strain (LAS-r), conduit phase of LAS (LAS-cd) did not show significant changes after the operation (for all, p>0.05). However, the absolute atrial contraction phase of LAS (LAS-ct) mean value increased significantly (14.2±8.8 vs 16.6±8.3, p=0.025) postoperatively. Among the conventional echo parameters, isovolumic relaxation time (IVRT) and the E/A ratio demonstrated notable postoperative alterations. The mean IVRT (87.3 ± 22.4 vs. 80.8 ± 18.1, p=0.014) and E/A ratio (1.5 ± 0.5 vs. 1.3 ± 0.3, p=0.012) exhibited a postoperative decline. Conclusions To the best of our knowledge, our study is the first to evaluate the effect of partial hepatectomy on cardiac functions by echocardiography in living liver donors, and there was no deterioration in the functions of both the ventricles and left atrium.
引言 我们旨在评估部分肝切除术对活体肝供者术后早期超声心动图常规参数和斑点追踪参数是否有影响。
方法 本研究是一项回顾性研究，在一家大型肝移植中心调查肝移植术后肝捐赠对心脏的影响。90名活体肝供者纳入研究。在手术前以及术后五至七天获取90名活体肝供者的超声心动图图像。由经验丰富的心脏病专家根据美国超声心动图学会的建议，使用飞利浦Epiq 7超声系统（飞利浦超声；美国华盛顿州博塞尔）对超声心动图检查进行评估。这些检查包括M型、二维成像、二尖瓣间隔和侧壁瓣环处的组织多普勒评估，以及所有患者在左侧卧位静息状态下的应变成像。分析活体肝供者超声心动图参数的变化。采用配对t检验评估显著差异。
结果 左心室（LV）整体纵向应变（GLS）、右心室（RV）GLS、RV游离壁纵向应变（LS）、左心房应变储备期（LAS-r）、LAS管道期（LAS-cd）术后均无显著变化（所有p>0.05）。然而，LAS绝对心房收缩期（LAS-ct）平均值术后显著增加（14.2±8.8对16.6±8.3，p=0.025）。在常规超声心动图参数中，等容舒张时间（IVRT）和E/A比值术后有明显改变。平均IVRT（87.3±22.4对80.8±18.1，p=0.014）和E/A比值（1.5±0.5对1.3±0.3，p=0.012）术后下降。
结论 据我们所知，我们的研究首次通过超声心动图评估部分肝切除术对活体肝供者心脏功能的影响，且心室和左心房功能均未恶化。
