Research Article Details

Article ID: A21540
PMID: 25243439
Source: Hellenic J Cardiol
Title: Evaluation of subclinical left ventricular systolic dysfunction using two-dimensional speckle-tracking echocardiography in patients with non-alcoholic cirrhosis.
Abstract: INTRODUCTION: Cirrhosis is associated with certain abnormalities in left ventricular (LV) structure and function. Two-dimensional speckle-tracking echocardiography (2D-STE) enables a rapid and accurate analysis of regional LV systolic mechanics in the longitudinal, radial and circumferential directions. The aim of this study was to precisely assess the differences among the 3 directions in the early impairment of LV myocardial contraction in non-alcoholic cirrhotic patients with preserved LV pump function. METHODS: A total of 75 subjects, including 38 cirrhotic patients and 37 healthy individuals, were enrolled. Using 2D-STE, the strain (S) and systolic strain rate (SRS) values belonging to the radial (R), circumferential (C), and longitudinal (L) functions of the LV were measured. RESULTS: In the cirrhotic group, the LS (20.57 &#177; 2.1 vs. 28.7 &#177; 43.1, p<0.001) and LSR-S (1.1 &#177; 0.24 vs. 1.6 &#177; 0.3) values were found to be lower, whereas the CS (24.82 &#177; 2.57 vs. 19.16 &#177; 4.58, p<0.001) and CSRS (1.41 &#177; 0.3 vs. 1.2 &#177; 0.4, p<0.004) values were found to be higher than in the healthy control group. The RS and RSR-S values did not differ among the groups. A relationship was observed between the MELD score, which shows the severity of the disease, and the CS value (&#226;: 0.211, p<0.01, 95%CI: 0.086-0.503). CONCLUSION: LV myocardial contraction was impaired in the longitudinal direction. However, LV pump function was augmented by the circumferential shortening during the ventricular systole. Using the 2D-STE method for the regional evaluation of the LV, the LV damage can be detected in the subclinical phase in cirrhotic patients.
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