The Evaluation Of Regional Myocardial Mechanics Of Right Ventricle In Patients With Liver Cirrhosis Using Echocardiographic Velocity Vector Imaging Combined With Isometric Stress Test

Objective: To study regional myocardial function of right ventricle atdifferent stages of cirrhosis, using echocardiograhpic velocity vector imagingcombined with standard isometric grip strength test to reveal the mechanicalfunction in patients with liver cirrhosis after isometric stress test further, andto benefit reliable quantitative evaluation and efficacy indicators for theestablishment of the early diagnostic criteria of cirrhotic cardiomyopathy byechocardiography, and found myocardial mechanics basis for explicitpathogenesis of cirrhotic cardiomyopathy.Methods: Accorded to Child-Pugh score, The cirrhosis experimental groupswere divided into three groups: group A (42patients), group B (28patients)and group C (12patients). there were31patients in group A to be conductedstandard isometric grip strength test. While34healthy people were selected asthe control group. Collecting the dynamic gray scale long-axis view images ofthe right ventricle in3complete cardiac cycles in apical four-chamber view.Peak systolic longitudinal velocity (Vsmax), peak systolic longitudinal strain (Smax) and strain rate(SRmax), peak systolic longitudinal displacement(Dmax)and global ejection fraction of the right ventricle were derived from6myocardial segments with the Syngo VVI workstation off-line.Results:1. Compared with the control group, in group A, global ejectionfraction of the right ventricle was normal, there were not significant change ofVsmax, Smax and SRmax of each segment (P>0.05), the Dmax of eachsegment increased mainly (P <0.05～0.01). In group B, there was notsignificant change of global ejection fraction of the right ventricle, the Vsmax,Smax, SRmax and Dmax of each segment were significantly increased (P<0.05～0.01). In group C, global ejection fraction of the right ventricle wassignificantly lower (P <0.01), the Smax, SRmax and Dmax of each segmentreduced mainly (P <0.05～0.01), the Vsmax of each segment was not obviousabnormality (P>0.05).2. Compared with group A, in group B, there was nosignificant difference of blood pressure and global ejection fraction of theright ventricle, while including the Vsmax, Smax, SRmax and Dmax of eachsegment in systole and diastole. Compared with group A and group B, ingroup C, systolic and diastolic blood pressure and global ejection fraction ofthe right ventricle decreased significantly; the Vsmax, Smax, SRmax andDmax of each segment were reduced mainly (P <0.05～0.01).3. Comparedwith the resting state, after the standard isometric grip strength test, the global ejection fraction of the right ventricle decreased significantly, there was asignificant reduction mainly in Vsmax, Smax, SRmax and Dmax of eachsegment(P <0.05～0.01).Conclusion: It is confirmed that the regional myocardial function of rightventricle in patients with liver cirrhosis is abnormality even at early stage angcould be revealed by standard isometric stress test. The right ventricularsystolic dyfunction is related to the stages of liver cirrhosis disease. Thesefindings will contribute to the proper clinical treatment and prevention ofglobal and regional myocardial dysfunction at different stages of cirrhosis.