Study On The Correlationship Between Liver Injury And Cardiac Structure And Function In Patients With Hepatic Echinococcosis

Objective: The purpose of this study is to explore the correlation-ship between the changes of liver structure and function and ventricular anatomy,movement and function caused by hepatic echinococcosis with routine abdominal ultrasound,transthoracic echocardiography combined with shear wave elastography,so as to evaluate the clinical value of the degree of liver injury and early cardiac function changes.Methods: 30 Tibetan patients with hepatic echinococcosis confirmed by postoperative pathology in our hospital from September 2020 to January 2021 are selected as the experimental group,another 20 cases from the same areas and who without liver occupany detected by routine liver ultrasound examination at the same time were selected as the control group.All participants in this study undergone routine liver ultrasound,shear wave elastography and transthoracic echocardiography to evaluate the lesions of hepatic echinococcosis,the degree of liver tissue injury and the early changes of cardiac structure and function.According to the results of serological examination of liver function,we divided all those subjects into three groups:(1)Normal liver function group;(2)Abnormal liver function group and(3)control group.All data were analyzed by SPSS 25.0 for normality and homogeneity of variance.Measurement data were expressed as x±s,and P < 0.05 indicated statistically significant differences.Results: 1.A total of 30 patients who were pathologically confirmed as hepatic echinococcosis were enrolled into this study as the experimental group,including 12 males and 18 females,with an average age of 15 to 62 years.Another 20 Tibetan residents who lived in the same area and had no liver lesions detected by ultrasound were enrolled into the control group,there were 13 males and 7 females,aged from 19 to 65 years old,with an average of 19 to 65 years old.2.Comparison of hepatic hemodynamic parameters among the three groups: the average diameter and velocity of portal vein,inferior vena cava and hepatic vein were the same among the three groups,and there was no significant difference among the three groups(p > 0.05).3.Comparison of elastography parameters among the three groups: the mean of elastography parameters of normal liver function group were significant higher than the group of abnormal liver function and control(p<0.05),and there were no significant difference between abnormal liver function group and control group(p > 0.05).4.Comparison of cardiac structural and functional parameters among the three groups: the means of pulmonary artery forward acceleration time(PVAT)of normal liver function group was significantly lower than the both of abnormal liver function(p=0.03)and control group(p=0.008),and the difference was statistically significant.Otherwise,the means of tricuspid annulus early diastolic tissue Doppler velocity(TV＿e’)and tricuspid annulus early and late tricuspid annulus diastolic tissue Doppler velocity ratio(TV＿e’/a’)in abnormal liver function group were obviously higher than in normal liver function and control group(p<0.05),the comparation of other cardiac structural and functional parameters were no statistical significance(p>0.05).5.Pearson correlation analysis of liver function and cardiac structure and function parameters: TBIL was negatively correlated with mitral valve early diastolic blood flow velocity(MV＿E)(r=-0.44,p=0.01),while TBIL was positively correlated with tissue Doppler velocity ratio of early and late tricuspid annulus diastole(r=0.52,p<0.001).Alanine aminotransferase(ALT)was negatively correlated with left ventricular endsystolic diameter(LVDd)(r=-0.37,p=0.03)and left ventricular posterior wall thickness(LVPWd)(r=-0.44,p=0.01),while ALT was positively correlated with interventricular septal late diastolic tissue Doppler velocity(septal＿a’)(r=0.74,p<0.001)and tricuspid annulus diastolic tissue Doppler velocity ratio(r=0.37,p=0.04).Conclusion: 1.In this study,the average hardness of liver tissue of patients with hepatic echinococcosis was expressively higher than that of recommended in guidelines,which confirmed the liver tissue damage caused by echinococcosis infection and promoted the occurrence of hepatic fibrosis and increased the hardness of liver tissue.2.The results of cardiac function parameters among the three groups suggested that when the hepatic echinococcosis patients with an abnormal liver function,the pulmonary artery pressure increases and further shorten the forward acceleration time of pulmonary artery,so that patients with abnormal liver function may have the higher pulmonary hypertension compared with normal liver function and control group.And the early diastolic tissue Doppler velocity of interventricular septum decreasedin patients with hepatic echinococcosis,while abnormal liver function could increase the early diastolic tissue Doppler velocity of tricuspid annulus,which probably suggest that the impairment of right ventricular diastolic function.3.When the liver function of patients with hepatic echinococcosis was impaired,the left ventricular volume and structural parameters of ventricular wall may be affected.And with the increases of ALT and TBIL,the thug function of the chamber was also probably impaired.