Disorders of heart structure and function parameters and hepatolienal blood flow remodeling in patients with virus-induced cirrhosis

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Aim. To study heart structure and function parameters and hepatolienal blood flow in patients with virus-induced cirrhosis (VIC). Materials and methods. 95 patients with VIC (mean age, 38.6; disease duration, 4.5 years) were evaluated. Doppler EchoCG and Doppler ultrasonic examination of hepatolienal vasculature (VIVID E 95 apparatus) were performed. The control group consisted of 19 healthy individuals. Statistical analysis was performed using the Statistica 6.0 software. Results. The study of hepatolienal blood flow showed that the splanchnic artery blood flow velocity was increased by 25%, the hepatic vein blood flow velocity was increased by 13%, and splanchnic arteries and veins were dilated. 24% of VIC patients had moderate pulmonary hypertension associated with a 20% dilatation of inferior vena cava (p=0.007), a 28% increase in hepatic vein blood flow velocity (p=0.0003), and a 13% decrease in portal vein diameter (p=0.001). Four types of left ventricular (LV) geometry were identified: 40% of VIC patients had normal geometry; 17% of patients had concentric hypertrophy; 23% of patients had concentric remodeling; and 19% had eccentric hypertrophy. Features of hepatolienal blood flow were related with the LV geometry type. LV diastolic filling was impaired in 44.3% and RV diastolic filling - in 33% of patients. In patients with VIC, the disturbed diastolic function was associated with 25% reduced hepatic vein blood flow velocity (p=0.05) whereas development of RV diastolic dysfunction was associated with 6% reduced portal vein diameter (p=0.04), 17% dilated portal vein (p=0.006), and 25% decreased portal vein blood flow velocity (p=0.00l). Anti-viral therapy resulted in improvement of some hepatolienal blood flow parameters. Parameters of splanchnic circulation were correlated with car-diodynamic parameters with correlation coefficients from 0.51 to 0.95 at p<0.05. Conclusion. In patients with VIC, disturbed ventricular diastolic function, LV architectonics, and increased pulmonary artery blood pressure were associated with more pronounced changes in parameters of splanchnic circulation. A course of anti-viral therapy improved some parameters of hepatolienal blood flow. Parameters of splanchnic circulation were interrelated with major ventricular structure and function parameters.

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