Myocardial structural and functional changes in patients with liver cirrhosis awaiting liver transplantation: a comprehensive cardiovascular magnetic resonance and echocardiographic study

被引：40

作者：

Kim, Hyue Mee ^{[1
,2
,3
]}

Kim, Hyung-Kwan ^{[1
,2
]}

Lee, Jeong-Hoon ^{[4
,5
]}

Lee, Yun Bin ^{[4
,5
]}

Park, Eun-Ah ^{[6
]}

Park, Jun-Bean ^{[1
,2
]}

Lee, Seung-Pyo ^{[1
,2
]}

Kim, Yoon Jun ^{[4
,5
]}

Kim, Yong-Jin ^{[1
,2
]}

Yoon, Jung-Hwan ^{[4
,5
]}

Sohn, Dae-Won ^{[1
,2
]}

机构：

[1] Seoul Natl Univ Hosp, Dept Internal Med, Div Cardiol, 103 Daehak Ro, Seoul 03080, South Korea

[2] Seoul Natl Univ Hosp, Cardiovasc Ctr, Sect Cardiovasc Imaging, 103 Daehak Ro, Seoul 03080, South Korea

[3] Chung Ang Univ Hosp, Div Cardiol, Dept Internal Med, Seoul, South Korea

[4] Seoul Natl Univ, Div Gastroenterol, Dept Internal Med, Coll Med, 103 Daehak Ro, Seoul 03080, South Korea

[5] Seoul Natl Univ, Liver Res Inst, Coll Med, 103 Daehak Ro, Seoul 03080, South Korea

[6] Seoul Natl Univ Hosp, Dept Radiol, Seoul, South Korea

来源：

JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE | 2020年 / 22卷 / 01期

关键词：

Extracellular volume fraction; Cardiovascular magnetic resonance; Left ventricle; Global longitudinal strain; Cirrhosis; VENTRICULAR DIASTOLIC FUNCTION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; FIBROSIS; HEART; RECOMMENDATIONS; QUANTIFICATION; DYSFUNCTION; DISEASE; UPDATE;

D O I：

10.1186/s12968-020-00622-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Cardiac dysfunction is increasingly recognized in patients with liver cirrhosis. Nevertheless, the presence or absence of structural alterations such as diffuse myocardial fibrosis remains unclear. We aimed to investigate myocardial structural changes in cirrhosis, and explore left ventricular (LV) structural and functional changes induced by liver transplantation. Methods This study included 33 cirrhosis patients listed for transplantation and 20 healthy controls. Patients underwent speckle-tracking echocardiography and cardiovascular magnetic resonance (CMR) with extracellular volume fraction (ECV) quantification at baseline (n = 33) and 1 year after transplantation (n = 19). Results CMR-based LV ejection fraction (CMRLV-EF) and echocardiographic LV global longitudinal strain (LV-GLS) demonstrated hyper-contractile LV in cirrhosis patients (CMRLV-EF: 67.8 +/- 6.9% in cirrhosis vs 63.4 +/- 6.4% in healthy controls, P = 0.027; echocardiographic GLS: - 24.2 +/- 2.7% in cirrhosis vs - 18.6 +/- 2.2% in healthy controls, P < 0.001). No significant differences in LV size, wall thickness, mass index, and diastolic function between cirrhosis patients and healthy controls were seen (all P > 0.1). Only one of the cirrhosis patients showed late gadolinium enhancement. However, cirrhosis patients showed a higher ECV (31.6 +/- 5.1% vs 25.4 +/- 1.9%, P < 0.001) than healthy controls. ECV showed a positive correlation with Child-Pugh score (r = 0.564, P = 0.001). Electrocardiogram-based corrected QT interval was prolonged in cirrhosis (P < 0.001). One-year post-transplantation, echocardiographic LV-GLS (from - 24.9 +/- 2.4% to - 20.6 +/- 3.4%, P < 0.001) and ECV (from 30.9 +/- 4.5% to 25.4 +/- 2.6%, P = 0.001) moved to the normal ranges. Corrected QT interval decreased after transplantation (from 475 +/- 41 to 429 +/- 30 msec, P = 0.001). Conclusions Myocardial extracellular volume expansion with augmented resting LV systolic function was characteristic of cirrhotic cardiomyopathy, which normalizes 1-year post-transplantation. Thus, myocardial extracellular expansion represents a structural component of myocardial changes in cirrhosis.

引用

页数：13

共 44 条

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