二维斑点追踪成像评价肝硬化失代偿期患者心室功能的价值

目的 探讨应用超声心动图结合斑点追踪成像技术评估肝硬化患者心室功能的价值.方法 纳入2017年1月至2019年12月暨南大学附属顺德医院收治的45例肝硬化患者,并从同期体检对象中选择年龄、性别相匹配的45名健康对照者.应用二维超声心动图和斑点追踪成像技术评估两组研究对象的左、右心室功能,观察并比较两组左、右心室结构和功...

Evaluation of ventricular function in patients with decompensated liver cirrhosis by echocardiography combined with speckle tracking imaging

Objectives To evaluate the ventricular function in patients with decompensated liver cirrhosis by echocardiography combined with speckle tracking imaging.Methods From January 2017 to December 2019,45 patients with liver cirrhosis were enrolled in The Affiliated Shunde Hospital of Jinan University,and 45 healthy controls matched by age and gender were selected from the same period of physical examination.Two-dimensional echocardiography and speckle tracking imaging were used to evaluate the left and right ventricular function of the two groups.The left and right ventricular structural and functional parameters including left ventricular global longitudinal strain(LVGLS),left ventricular global circumferential strain(LVGCS),left ventricular global radial strain(LVGRS)and right ventricular global longitudinal strain(RVGLS)were observed and compared.The correlations between model for end-stage liver disease(MELD)score and LVGLS and RVGLS were analyzed.Results left ventricular end diastolic volume(LVEDV)[(94.02±29.71)mL vs.(74.38±16.42)mL,P<0.05],left ventricular end systolic volume(LVESV)[(33.42±8.72)mL vs.(26.58±6.45)mL,P<0.05],interventricular septum thickness(IVS)[(1.12±0.23)mm vs.(0.98±0.14)mm,P<0.05],right ventricular end diastolic area(RVEDA)[(13.91±3.92)cm2 vs.(12.05±2.58)cm2,P<0.05],right ventricular end systolic area(RVESA)[(6.62±1.45)cm2 vs.(5.71±1.53)cm2,P<0.05],right ventricular pressure(RVP)[(25.38±5.84)mmHg vs.(15.66±4.35)mmHg,P<0.05](1 mmHg=0.133 kPa)and E/E′(8.57±2.32 vs.6.72±1.46,P<0.05)in liver cirrhosis group were significantly higher than those in control group(P<0.05);Left ventricular ejection fraction(LVEF)between the two groups had no significant difference(P>0.05).LVGLS(-17.62%±2.61%vs.-20.13%±2.84%,P<0.05),LVGCS(-16.63%±2.45%vs.-21.62%±3.61%,P<0.05),LVGRS(38.94%±4.12%vs.45.49%±5.33%,P<0.05)and RVGLS(-21.22%±4.40%vs.-23.86%±2.63%,P<0.05)in liver cirrhosis group were significantly lower than those in control group(P<0.05).MELD score in liver cirrhosis group showed significant negative correlations with LVGLS(r=-0.709,P<0.05)and RVGLS(r=-0.699,P<0.05).Conclusions Patients with liver cirrhosis have left and right ventricular dysfunction,and the severity of liver disease significantly relats to the impairment of left and right ventricular function.Echocardiography combined with speckle tracking imaging can be used as a sensitive tool to evaluate the subclinical ventricular systolic and diastolic function in patients with liver cirrhosis.