![]() ![]() However, patients were excluded if any of the following potential confounding or complicating factors were present: previous heart disease (i.e. All 138 patients with cirrhosis diagnosis underwent cardiac assessment with continuous-wave Doppler echocardiography and were recruited for study. The cirrhosis diagnosis was based on accumulated findings for patient medical record, clinical manifestations, laboratory findings, liver B-ultrasound and/or computed tomography (CT) scan, or liver biopsy. Patients with a liver cirrhosis diagnosis who were hospitalized for treatment at the Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine (Shaanxi, China) between June 2012 and June 2014 were considered for study enrollment. In this study, we applied the MELD scoring system to assess the severity of liver disease in patients with cirrhosis and used echocardiography to assess these patients’ cardiac structure and function, moreover, to analyze the potential correlation between the disease severity and cirrhosis-related left ventricular remodeling and functional changes. The MELD scoring system was designed to provide a more accurate assessment of liver disease and takes into account renal insufficiency, the etiology of cirrhosis, etc. Unfortunately, some of the indexes of this system may be influenced by subjective factors, such as ascites and hepatic encephalopathy. The Child-Pugh scoring system is the most commonly used clinical method for classifying liver cirrhosis. Although some studies have shown no direct relationship between the degree of liver dysfunction and extent of changes in cardiac function, others reported the most pronounced cardiac dysfunction in patients with higher model for end-stage liver disease (MELD) score. The relationship between the severity of liver disease and cirrhotic cardiomyopathy is controversial. The potential for missed diagnosis of CCM in cirrhotic patients remains a particular concern in clinical practice since cardiac dysfunction in whom is associated with worse prognosis and higher risk of death. In these patients, the clinical manifestation of increased cardiac output and visceral blood flow, decreased systemic vascular resistance and mean arterial blood pressure, dysfunctional ventricular diastolic and/or systolic dysfunction, and mild tachycardia, as well as electromechanical abnormalities with prolonged QT interval without other known causes of cardiac disease, is defined as cirrhotic cardiomyopathy (CCM). The pathogenic processes of liver cirrhosis lead to changes in cardiac structure and function. Left atrial enlargement and VE/VA ratio ≤ 1 may serve as useful diagnostic indexes for cirrhotic cardiomyopathy. Conclusions: Patients with cirrhosis had impaired cardiac function, mainly present as left ventricular diastolic dysfunction, and the extent of dysfunction was correlated with the MELD score. LAD, LVEDD and DT were positively correlated with MELD score (r = 0.208, 0.319 and 0.197, respectively all P < 0.05). Nearly one-half of the cirrhotic patients showed left atrial enlargement and a VE/VA ratio ≤ 1, and these features were more common in patients with MELD score ≥ 20. Subgroup analysis showed that the higher the MELD score, the greater the increase in LVESD, LVEDD, IVST, LAD and DT (all P < 0.05). Results: The cirrhotic patients had significantly higher LVESD, LVEDD, IVST, LAD, CO and DT than the control group, but significantly lower VE/VA ratio (all P < 0.05). All study participants underwent cardiac assessment of the left ventricle with Doppler echocardiography the parameters assessed included left ventricular-end systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left atrial diameter (LAD), left ventricular ejection fraction (LVEF), cardiac output (CO), mitral flow velocity (VE/VA ratio), and E-wave deceleration time (DT). Thirty healthy individuals were enrolled as controls. Methods: A total of 89 cirrhotic patients were enrolled for study and subgrouped according to MELD score: ≤ 9, 10-19, and ≥ 20. Objective: The purpose of our study is to investigate cirrhosis-related left ventricular remodeling and functional changes, further to analyze the correlations with model for end-stage liver disease (MELD) score. ![]()
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