UNASSIGNED: A total of 203 cirrhosis patients were enrolled and underwent investigations, including 2-dimensional echocardiography with tissue Doppler imaging, and 139 patients with LVDD (cases) were compared with 64 patients without LVDD (controls). Logistic regression and Kaplan-Meier analysis were applied.
UNASSIGNED: Mean age was 52.76±10 years. Among LVDD patients, 56% had grade-1, and 44% had grade-2 LVDD. Cirrhosis related to NASH had a more significant association with LVDD (P<0.001) than other etiologies. LVDD was significantly associated with a greater incidence of Child-Turcotte-Pugh (CTP) class C (P<0.001), higher model for end-stage liver disease scores (P=0.001), duration of cirrhosis >2 years since diagnosis (P=0.028), ascites (P<0.001), hepatic encephalopathy (P<0.010), hepatorenal syndrome (P<0.001), and a history of obesity (P=0.004). Multivariate analysis showed that higher CTP score, ascitic fluid protein and prolonged QTc interval were independently associated with LVDD (P=0.009; P=0.018; P=0.016, respectively). Kaplan-Meier survival analysis showed significantly poorer survival status in patients with higher grades of LVDD (P<0.001). The area under the receiver operating characteristic curve (0.78) was greatest for ascitic fluid protein in predicting LVDD, with a cutoff of >1 g/dL.
UNASSIGNED: Higher CTP score, prolonged QTc, higher ascitic fluid protein levels, and poor survival are significantly associated with LVDD. Ascitic fluid protein >1 g/dL could be an indicator for evaluating LVDD.
■共纳入203例肝硬化患者并接受调查,包括组织多普勒成像的二维超声心动图,将139例LVDD患者(病例)与64例无LVDD患者(对照组)进行比较。采用Logistic回归和Kaplan-Meier分析。
■平均年龄为52.76±10岁。在LVDD患者中,56%为1级,44%为2级LVDD。与NASH相关的肝硬化与LVDD的相关性高于其他病因(P<0.001)。LVDD与Child-Turcotte-Pugh(CTP)C级的发生率显着相关(P<0.001),终末期肝病评分较高的模型(P=0.001),自诊断以来肝硬化的持续时间>2年(P=0.028),腹水(P<0.001),肝性脑病(P<0.010),肝肾综合征(P<0.001),有肥胖病史(P=0.004)。多因素分析显示CTP评分较高,腹水蛋白和QTc间期延长与LVDD独立相关(P=0.009;P=0.018;P=0.016)。Kaplan-Meier生存分析显示,LVDD评分较高的患者的生存状态明显较差(P<0.001)。腹水蛋白预测LVDD的受试者工作特征曲线下面积(0.78)最大,截止值>1g/dL。
■更高的CTP分数,QTc延长,更高的腹水蛋白水平,低生存率与LVDD显著相关。腹水蛋白>1g/dL可作为评价LVDD的指标。