A Clinical Study Of Ventricular Function In Patients With Cirrhosis During Different Periods By Ultrasonography

Part1A Clinical Study Of Left Ventricular Function In Patients WithCirrhosis During Different Periods By UltrasonographyObjective: Application of real-time three-dimensional echocardiography(RT-3DE) measurement of left cardiac function changes of patients with livercirrhosis in different periods to investigate (1) If the left cardiac function inpatients with cirrhosis have change, and how changes in different periods;(2)Comparing RT-2DE to RT-3DE to evaluate the cardiac systolic function incirrhosis patients.Methods:62patients with liver cirrhosis (ruled out organic heart disease,diabetes, hypertension and other diseases of the patients) were selected asexperimental group and based on the Child-Hugh grading divide into A-level,B-level and C-level, and another30healthy volunteers who ruled out organicheart disease, diabetes, hypertension and other diseases as control groupbetween November2011and December2012. All subjects underwentconventional echocardiography, RT-3DE examinations, and recorded clinicaland laboratory results. The parameters to evaluation left cardiac functionincluding: Ejection Fraction (EF), Stroke Volume (SV), Mitral valve earlydiastolic peak velocity（E）and late diastolic peak velocity(A) and E/A.Results:1. Compared with normal control group of patients with liver cirrhosis:E/A was decreased.(Prespectively<0.01); A>control group(P<0.01); E, LVEF and LVSV have no obvious significance compare with control group (P>0.05).2. The Liver cirrhosis patients at all levels are compared with controlgroup: LVEF and LVSV: A and C have no obvious significance comparewith control group (P>0.05), B>control group (P<0.05); E/A: controlgroup>A, B, C (P<0.05,);3. The Liver cirrhosis patients are compared between at all levels: LVEFand LVSV:A<B(P<0.05),A and C have no obvious significance(P>0.05),B>C(P<0.05); E/A:A>B>C(P<0.05).4.The correlation analysis between2DE and3DE to evaluate cardiacfunction: the3DE correlated significantly with2DE(LVEF: r=0.79，P<0.05,LVSV: r=0.61, P<0.05)．Conclusion:1. The left cardiac function Existence changes in cirrhosis patients,especially the left ventricular diastolic function.2. With the degree of liver damage, cardiac function damage is moreobvious in cirrhosis patients.3. RT-3DE is very sensitive to general evaluation of cardiac function. Part2A Clinical Study Of Right Ventricular Function In Patients WithCirrhosis During Different Periods By UltrasonographyObjective: Application of real-time three-dimensional echocardiography(RT-3DE), Two-dimensional Strain (S) measurement ofright cardiac function changes of patients with liver cirrhosis in differentperiods to investigate (1) If right cardiac function in patients with cirrhosis have change, and how changes in different periods;(2)Two-dimensional strainimagingin liver cirrhosis patients with accuracy and feasibility of heartfunction.Methods:62patients with liver cirrhosis (ruled out organic heart disease,diabetes, hypertension and other diseases of the patients) were selected asexperimental group and based on the Child-Hugh grading divide into A-level,B-level and C-level, and another30healthy volunteers who ruled out organicheart disease, diabetes, hypertension and other diseases as control groupbetween November2011and December2012. All subjects underwentconventional echocardiography, RT-3DE examinations, and recorded clinicaland laboratory results. The parameters to evaluation right cardiac functionincluding: peak systolic strain (PSS) of each segment of right ventricular,Ejection Fraction (EF), Stroke Volume (SV), Tricuspid early diastolic peakvelocity(e) and late diastolic peak velocity(a) and e/a.Results:1. Compared with normal control group of patients with livercirrhosis: e,e/a,RVEF,RVSV and PSS of each segment of right ventricularwere decreased.(Prespectively<0.05,<0.01,<0.05,<0.05,<0.01); a> controlgroup(P<0.05).2. The Liver cirrhosis patients at all levels are compared with controlgroup:e,e/a: control group>A,B,C(P<0.05,);RVEF and RVSV:controlgroup>A,B,C(P respectively>0.05,<0.05,<0.05); PSS of each segment ofright ventricular: A have no obvious significance compare with controlgroup(P>0.05),B and C<control group(P<0.05,P<0.05);A anda:A,B,C>control group(P<0.01, P<0.05).3. The Liver cirrhosis patients are compared between at all levels: RVEF and RVSV:B and C<A(P<0.05),B have no obvious significance compare withC(P>0.05); PSS of each segment of right ventricular: A>B>C(P<0.05);e,aand e/a: A>B and C(e and e/a)(P<0.05),A<B and C(a)(P<0.05),B have noobvious significance compare with C(P>0.05).Conclusion:1. The right cardiac function Existence changes in cirrhosis patients.2. With the degree of liver damage, right cardiac function damage ismore obvious in cirrhosis patients.3. The S can be a very good reaction right heart function.