ABSTRACT
Objective ToMeasureofleftventricularregionalsystolicfunctioninpatientswithcirrhosisby2DGSTItechnology.To exploretheclinicalvalueofleftventricularsystolicfunctionindifferentChildGPughgradedlivercirrhosispatientsanditscorrelation withthedegreeoflivercirrhosis.Methods Toselecting60casesoflivercirrhosispatientsincirrhosisgroup.AccordingtotheChildGPugh classification,thepatientsinA,BandCgradesweredividedintoA,BandCgroups.Toselecting30outpatientswithphysicalexaminations, whoseageandgendermatchedwithcirrhosispatientsatthesameperiodasnormal/controlgroup.Measuredtheconventionalindexes, andanalysedtwoGdimensionaldynamicimagesoftwoGchamber,threeGchamber,fourGchamberviewofapical.Thedifferencesinstrain indexandrelatedparametersbetweenthecirrhosisgroupsandthenormalcontrolgroupwerecompared.Results (1)Betweenliver cirrhosisgroupandcontrolgroup,therewerestatisticaldifferencesinheartrate,interventricularseptumthicknessandleftventricular enddiastolicvolume(P＜0.05).leftventricularejectionfraction wassignificantlylowerintheChildCgroupthanintheChild A groupandtheChildBgroup(P＜0.05),andwassignificantlyhigherintheChildBgroupthanthecontrolgroup(P＜0.05).Withthe increaseofChildGPughscoreinlivercirrhosisgroup,interventricularseptumthickness,leftatrialanteroposteriordiameter,leftventricular enddiastolicdiameterandleftventricularenddiastolicvolumeweregraduallyincreasing.Therewerestatisticallysignificantdifferences betweensomegroups(P＜0.05);(2)Longitudinalsystolicpeakstrainofeachsegmentofleftventricularwallwasgenerallylowerin thelivercirrhosisgroupthanthecontrolgroup,andthestrainin bothgroupsshowedincreasingtrendfromthebasaltotheapical segments.There werestatisticallysignificantdifferences between partialsegment(P＜0.05);(3)WiththeincreaseofChildGPugh scoreincirrhosisgroup,longitudinalsystolicpeakstrainofthe leftventricularwallgraduallydecreased.ChildCgroupcomparedwithothergroups,theleftventricularlongitudinalstrainaverage valuedifferencewasstatisticallysignificant(P＜0.05).Therewerestatisticallysignificantdifferencesinpartialsegmentbetweenthe othergroups(P＜0.05).Conclusion (1)2DGSTItechnologycanbesensitiveandreliabletodetectsubGclinicalmyocardialregional systolicdysfunctioninpatientswithcirrhosis;(2)LeftventricularsystolicfunctionisnegativelycorrelatedwithChildGPughgradein patientswithlivercirrhosis.
ABSTRACT
Objective To investigate the clinical value of assessment of the left ventricular function in pa-tients with post-hepatitis b cirrhosis using Tei index and its related parameters measured by Tissue Dopple Imaging. Methods Ninety-seven subjects were enrolled,with 43 ones in the normal control group,and 54 ones in the post-hepatitis b cirrhosis group. According to the Child-Pugh grading standard,patients in the post-hepatitis b cirrhosis group were divided into grade Child A(24 cases),grade Child B(15 cases)and grade Child c(15 cases). Color ul-trasonograph was used to detect the left ventricle Tei indexes of patients in each group,and comparison was made in the differences of the parameters among all groups. Results (1)The Tei index,IRT/ET and ICT/ET of left ven-tricular in the liver cirrhosis group were higher than those in the normal/control group,with significant differences between the two groups(P < 0.05). The Tei index,IRT/ET and ICT/ET of the left ventricular increased gradually in patients of grade Child A,B,and C,and significant differences were observed in Tei index,IRT/ET(P < 0.05), but no significant diference in ICT/ET was found.(2)There were no significant difference in LVEF and Ea/Aa be-tween the cirrhosis group and the normal control group. LVEF and Ea/Aa in grade Child C were significantly lower than those in the normal control group(P < 0.05). Conclusion Tei index is superior to conventional echocardiog-raphy on assessment of the left ventricular function in patients with liver cirrhosis. Patients with higher the Child-Pugh score may be suffered from the worse the left ventricular function,especially the diastolic dysfunction.