Changes in structure and function parametersof the left heart in patients with chronic hepatitis and cirrhosis of viral etiology
Background. In the recent decade, incidence of chronic diffuse liver diseases of viral origin has been increasing. Aim. To study features of the left heart structure and function condition in patients with chronic hepatitis (CH) and cirrhosis (CR) of viral origin. Materials and methods. 80 patients with chronic viral hepatitis and 78 patients with viral CR were evaluated. The control group consisted of 50 individuals without apparent disease. A profound EcoCG study using an ultrasound scanner “Vivid-7” (GE) was performed for all patients. Results. Remodeling with development of LV myocardial hypertrophy (LVMH) was observed in 62.5 % of patients with CH. The structural remodeling of the left heart in CH generally was adaptive; diastolic dysfunction with impaired active relaxation and increased LV myocardial stiffness were less pronounced than in CR. Remodeling with development of LVMH was observed in 93.6 % of CR patients; concentric LVMH formed in 76.9% of cases. Conclusion. The process of structural geometric remodeling of the left heart was associated with development of hypertrophic left heart remodeling more frequently in CR than CH patients. In addition, this process was disadaptive, associated with development of myocardial insufficiency, distortion of LV diastolic filling, and in some cases, formation of pseudonormal and restrictive types of diastolic dysfunction.