肝硬変患者における左室収縮機能早期評価のための第1相駆出率

PurposeFirst-phase ejection fraction has been established as an innovative indicator for detecting early left ventricular systolic changes. This study aimed to use first-phase ejection fraction to assess early changes in the left ventricular systolic function in patients with cirrhosis.MethodsIn this cross-sectional study, 122 patients with cirrhosis were stratified into the following groups based on Child-Turcotte-Pugh scores: group B1 (Child-Turcotte-Pugh class A, n = 35), group B2 (Child-Turcotte-Pugh class B, n = 43), and group B3 (Child-Turcotte-Pugh class C, n = 44). Thirty-nine healthy controls (group A) were enrolled for comparison. Basic information, clinical biochemical parameters, and ultrasound parameters were collected.ResultsCompared with groups A, B1, and B2, group B3 showed significantly decreased left ventricular ejection fraction (all p < 0.05). Groups B2 and B3 showed significantly decreased absolute values of global longitudinal strain compared with groups A and B1 (all p < 0.05). Compared with group B2, group B3 demonstrated more pronounced decrease in absolute values of global longitudinal strain (p < 0.05). First-phase ejection fraction was significantly increased in group B1 compared with that in group A (p < 0.05). In contrast, first-phase ejection fraction was significantly decreased in groups B2 and B3, with group B3 showing a further significant decrease compared with group B2 (p < 0.05). First-phase ejection fraction, ejection fraction, and global longitudinal strain demonstrated significant negative correlations with Child-Turcotte-Pugh class (r = -0.619, -0.429, and -0.608, respectively; p < 0.05). The prevalence of cirrhotic cardiomyopathy was significantly higher in group B3 than in group B1. The area under the receiver operating characteristic curve for first-phase ejection fraction in diagnosing cirrhotic cardiomyopathy was superior to that for ejection fraction and global longitudinal strain.ConclusionFirst-phase ejection fraction sensitively detects early alterations in left ventricular systolic function in cirrhotic patients and may facilitate early identification of cirrhotic cardiomyopathy.