Evaluacija parametara miokardne funkcije u razvoju cirotične kardiomiopatije
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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 th...e 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.