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Abstract：
UNASSIGNED: Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cirrhotic cardiomyopathy. Few studies have addressed its clinical significance in cirrhosis. We assessed the association of LVDD with the factors affecting cirrhosis patients\' severity, complications, and survival.
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.
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.
摘要：
■左心室舒张功能障碍（LVDD）是肝硬化心肌病的早期表现。很少有研究探讨其在肝硬化中的临床意义。我们评估了LVDD与影响肝硬化患者严重程度的因素的相关性，并发症,和生存。
■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。
■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。
