无创左心室压力-应变循环技术在左心室功能参数与肝硬化的相关性分析

Correlation analysis between left ventricular function parameters and liver cirrhosis using non-invasive left ventricular pressure-strain cycle

目的 探讨无创左心室压力-应变循环技术(LVPSL)与肝硬化患者肝功能分级(ChildPugh)之间的相关性。方法 前瞻性纳入2020年1月1日至2022年12月31日山东大学齐鲁医院德州医院收治的肝硬化患者120例及健康对照40例。根据Child-Pugh评分,将肝硬化患者分为三个亚组,Child-Pugh A级组(A组)、B级组(B组)和C级组(C组),各40例。采集常规超声心动图参数、左心室整体纵向应变(LVGLS)、左心室整体做功指数(GWI)、整体有效做功(GCW)、整体无效做功(GWW)和整体做功效率(GWE)参数。分析常规超声心动图参数、GLS、GWWI、GCCW、GWW和GWI与Child-Pugh评分之间的相关性。结果 与对照组相比,肝硬化组常规超声心动图参数无明显改变,而LVGLS、GWI、GCW和GWE明显降低,GWW升高(P <0.01);与肝硬化A组比较,B组LVGLS、GWI、GCW和GWE降低,而GWW升高(P <0.01);与肝硬化B组比较,C组LVGLS、GWI、GCW和GWE降低,而GWW升高(P <0.01);肝硬化患者的Child-Pugh评分与LVGLS的绝对值、GWI、GCW、GWE呈负相关(r=-0.624,-0.586,-0.674,-0.589),与GWW呈正相关(r=0.724)。结论 基于LVPSL技术测量的GWI、GCW、GWE和GWW可定量分析不同肝功能分级肝硬化心肌做功情况。

ObjectiveTo investigate the correlation between non-invasive left ventricular pressure-strain cycling(LVPSL)and Child-Pugh in patients with cirrhosis.MethodsA total of 120 patients with cirrhosis and 40 healthy controls admitted to Dezhou Hospital, Qilu Hospital of Shandong University from January 1, 2020 to December 31, 2022 were prospectively included.According to the Child-Pugh score, patients with cirrhosis were divided into three subgroups: Child-Pugh class A group(A group, n=40), class B group(B group, n=40)and class C group(C group, n=40). Conventional echocardiographic parameters, left ventricular global longitudinal strain(LVGLS), left ventricular global work index(GWI), global constructive work(GCW), global wasted work(GWW), and global work efficiency(GWE)were collected.The correlation of conventional echocardiographic parameters, GLS, GWI, GCW, GWW and GWI with Child-Pugh score in cirrhotic patients was analyzed.ResultsCompared with the control group, conventional echocardiographic parameters in the cirrhosis group had no significant changes, but LVGLS, GWI, GCW and GWE were significantly decreased, while GWW was increased(P<0.01). Compared with the cirrhosis A group, LVGLS, GWI, GCW, and GWE in the B group were decreased, while GWW was increased(P<0.01). Compared with the cirrhosis group B, LVGLS, GWI, GCW and GWE in the C group were decreased, while GWW was increased(P<0.01). The Child-Pugh score of cirrhosis patients was negatively correlated with the absolute value of LVGLS, GWI, GCW, and GWE(r=-0.624, -0.586, -0647, -0.589), and positively correlated with GWW(r=0.724).ConclusionGWI, GCW, GWE and GWW based on the LVPSL technique can be used to quantitatively analyze myocardial work of different liver function grades.