gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1334Research ArticleГЕПАТОЛОГИЯHEPATOLOGYДиастолическая дисфункция миокарда и изменение интервала Q–T при хроническом гепатите CDiastolic dysfunction of myocardium and change of Q–T interval at chronic hepatitis CКонышеваА. А.KonyshevaA. A.СагиноваЕ. А.SaginovaYe. A.МоисеевС. В.MoiseyevS. V.КрасноваТ. Н.KrasnovaT. N.АбдурахмановД. Т.AbdurakhmanovD. T.2012011120122263843Copyright © Конышева А.А., Сагинова Е.А., Моисеев С.В., Краснова Т.Н., Абдурахманов Д.Т., 20122012Конышева А.А., Сагинова Е.А., Моисеев С.В., Краснова Т.Н., Абдурахманов Д.Т.Konysheva A.A., Saginova Y.A., Moiseyev S.V., Krasnova T.N., Abdurakhmanov D.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1334

Цель исследования. Изучение функциональных изменений сердечно-сосудистой системы у больных вирусными заболеваниями печени.Материал и методы. В исследование были включены 150 пациентов с заболеваниями печени, вызванными вирусом гепатита С, в том числе 80 с хроническим гепатитом и 70 – с циррозом печени (ЦП). Всем больным проводили электро и эхокардиографию, а также пробу Реберга с расчетом фильтрационной фракции натрия. При анализе ЭКГ рассчитывали скорректированный интервал Q–T (Q–Tс) по формуле Базетта.Результаты. У больных ЦП обнаружено удлинение интервала Q–Tc (432±21 мс) по сравнению с таковым у больных гепатитом (412±20 мс) – р<0,001. Отмечена прямая корреляция длительности удлинение интервала Q–T и тяжести цирроза. При эхокардиографии у больных ЦП наблюдали ухудшение диастолической функции и утолщение стенок левого желудочка по сравнению с таковыми у больных гепатитом. Гипертрофию миокарда выявили у 5,0% больных гепатитом и 17,1% больных циррозом (р<0,05), диастолическую дисфункцию левого желудочка – у 20,0 и 50,0% соответственно. Фильтрационная фракция натрия у пациентов с декомпенсированным ЦП была достоверно ниже, чем у больных с компенсированным циррозом и гепатитом.Выводы. У больных на стадии цирроза печени достоверно чаще (в 40% случаев) встречается удлинение интервала Q–Tc по сравнению с больными на стадии гепатита (6,25%). Средняя длительность интервала Q–Tc – 432±21 и 412±20 мс соответственно (р<0,001). Диастолическая функция миокарда значительно ухудшается у больных циррозом по сравнению с больными на стадии гепатита (соотношение Е/А составило 1,01±0,29 и 1,29±0,39 соответственно, р<0,001). У больных ЦП, особенно в стадии декомпенсации, отмечается значимое уменьшение фильтрационной фракции натрия (0,52±0,21%) по сравнению с больными гепатитом (0,80±0,29%, p=0,01) и компенсированным циррозом (0,75±0,22, p=0,021).

Aim of investigation

Aim of investigation. To study the functional changes of cardio-vascular system in patients with viral liver diseases.

Material and methods

Material and methods. Overall 150 patients with hepatitis virus C-associated liver diseases, including 80 patients with chronic hepatitis and 70 – with liver cirrhosis (LC) have been included in original study. All patient underwent electro- and echocardiography, and Reberg test with calculation of sodium filtration fraction. At ECG analysis corrected Q-T (Q-Tс) interval was calculated by Bazett's formula.

Results

Results. In LC patients elongation of Q–Tc interval (432±21 ms) was revealed in comparison to patients with hepatitis (412±20 ms, р<0,001). Direct correlation of Q–T interval elongation and cirrhosis severity was marked. At echocardiography in LC patients the impairment of diastolic function and thickening of left ventricular walls was observed in comparison to hepatitis patients. Hypertrophy of myocardium was detected in 5,0% of patients with hepatitis and 17,1% of cirrhotic patients (р<0,05), diastolic dysfunction of left ventricle – in 20,0 and 50,0% respectively. The sodium filtration fraction in patients with decompensated LC was significantly lower, than in patients with compensated cirrhosis and hepatitis.

Conclusions

Conclusions. In patients at liver cirrhosis stage elongation of Q-Tc interval was significantly more frequent (40% of cases) in comparison to patients at hepatitis stage (6,25%). Mean duration of Q-Tc interval was 432±21 ms and 412±20 ms respectively (р<0,001). Diastolic function of myocardium considerably worsens at patients with cirrhosis in comparison to patients at hepatitis stage (Е/А ratio was 1,01±0,29 and 1,29±0,39 respectively, р<0,001). In patients with LC, especially at decompensation stage, significant decrease of sodium filtration fraction (0,52±0,21%) was marked in comparison to patients with hepatitis (0,80±0,29%, p=0,01) and compensated cirrhosis (0,75±0,22, p=0,021).

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The authors declare that there are no conflicts of interest present.