Title of article :
Myocardial contractile dispersion: A new marker for the severity of cirrhosis?
Author/Authors :
Moaref, Alireza Department of Cardiovascular Medicine - Shiraz University of Medical Sciences, Shiraz, Iran , Zamirian, Mahmood Department of Cardiovascular Medicine - Shiraz University of Medical Sciences, Shiraz, Iran , Mirzaei, Hamed Students’ Research Committee - Shiraz University of Medical Sciences, Shiraz, Iran , Attar, Amin Department of Cardiovascular Medicine - Shiraz University of Medical Sciences, Shiraz, Iran , Nasrollahi, Elham Students’ Research Committee - Shiraz University of Medical Sciences, Shiraz, Iran , Bahramvand, Yaser Students’ Research Committee - Shiraz University of Medical Sciences, Shiraz, Iran
Abstract :
Introduction: Cirrhotic cardiomyopathy (CCM) develops in about half of all cirrhotic patients,
affecting the long-term morbidity and mortality. Although some studies have shown an increased
QT-interval in cirrhotic patients, no evidences of myocardial contractile and QT dispersion (QTd)
changes are available. This study aimed to compare myocardial contractile dispersion (MCd), using
tissue Doppler imaging (TDI), as well as QTd between cirrhotic patients and healthy individuals,
investigating their associations with cirrhosis severity.
Methods: This prospective cross-sectional study was conducted on patients with confirmed liver
cirrhosis and healthy individuals. Participants with structural heart disease, heart ventricular
pacing, electrolyte abnormalities, using drugs affecting QT interval were excluded. All individuals
underwent 2D echocardiography, and TDI by vivid E9 echo machine. MCd and QTd were considered
as main outcomes. Chi-square, independent-sample t test, and Pearson correlation test, were used for
statistical analyses by SPPS version 17.0. P value <0:05 was considered statistically significant.
Results: Sixty participants (40 male/20 female) with a mean age of 40.1 ± 7.1 years in two groups of
cirrhotic patients (n=30) and healthy individuals (n=30) were studied. Both groups were statistically
similar in terms of age (P = 0.31) and gender (P = 0.39). MCd and QTd of cirrhotic patients were
significantly higher than healthy individuals (MCd: 41.0 ± 26.8 versus 27.6 ± 18.1; P = 0.028; and QTd:
37.0 ± 22.1 versus 25.3 ± 8.9; P = 0.010). Cirrhotic patients with MELD score <15 had a lower MCd in
comparison to score ≥15 (29.2 ± 13.8 versus 50.0 ± 31.1, P = 0.034).
Conclusion: Cirrhosis was associated with increased MCd, assessed by TDI. Also, MCd and QTd
were associated with a higher MELD score. According to the results, it seems that MCd and QTd
might be useful predictor of ventricular arrhythmia and negative prognostic factor in cirrhotic
patients.
Keywords :
Cirrhotic Cardiomyopathy , QT Dispersion , Tissue Doppler Imaging , Myocardial Contractile Dispersion
Journal title :
Journal of Cardiovascular and Thoracic Research (JCVTR)