Evaluacija parametara miokardne funkcije u razvoju cirotične kardiomiopatije

Abstract

Backgorund/Aim. Cirrhotic cardiomyopathy (CCM) is a clinical syndrome in liver cirrhosis (LC) patients (pts), witch is characterized by abnormal cardiovascular (CV) response to physiologic, pathologic, or pharmacologic stress provocation, but increased cardiac output and contractility at rest. The aim of the study was to identify the structural and functional myocardial changes in LC pts , by two-dimensional echocardiography (EC) Doppler imaging evaluation in prediction of CCM. Methods. The research was performed as a prospective, case-control study, on selected 40 pts with LC and negative personal medical history on previous CV disease and 40 healthy subjects as a control, from January 2012.-December 2014. year. There were determining a significant ECG, EC and serum markers of myocardial dysfunction of LC pts in prediction of CCM. Results. Most of the LC patients were alcoholic one (80.0%), dominantly in Child-Pough C stage (70.0%). The average value of QTc interval in the LC pts was significantly higher (0.44±0.03 vs. 0.42±0.01 s; p<0.001), as well as serum brain natriuretic peptide (BNP) level (284.61±181.44 vs. 69.41±31.08 ng/l; p<0.001) compare to health subjects. There were strong association between serum BNP level values in LC pts and values of : left atrial (LA) diameter (p=0.031), left ventricular ejection fraction (LVEF) (p=0.014), pulmonary artery systolic pressure (PASP) (p=0.000) and the presence of tricuspid valve regurgitation (TVR) of 2+ (p=0.000), affecting its change of 41.6%. Conclusion. The obtained results suggests that LC pts had significant ECG and EC signs for myocardial dysfunction and the increased BNP serum level. LA diameter, LVEF, PASP and TVR are valuable EC predictors of CCM.