ObjectiveTo investigate the association of liver stiffness measurement (LSM) and serum biochemical parameters with hepatic steatosis, liver inflammation, and liver fibrosis in patients with nonalcoholic steatohepatitis (NASH). MethodsA total of 520 patients with NASH who were treated in The Fifth Medical Center of Chinese PLA General Hospital from January 2007 to December 2018 were enrolled, and according to body mass index (BMI) with a cut-off value of 28 kg/m2, the patients were divided into obese group with 151 patients and non-obese group with 369 patients. All patients underwent liver biopsy, and LSM was measured within 3 days before biopsy. Serum biochemical parameters and general clinical data were collected before liver biopsy, and the noninvasive indices aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4) were calculated. The t-test was used for comparison of normally distributed continuous between groups, the nonparametric Mann-Whitney U test was used for comparison of non-normally distributed continuous between groups; the chi-square test was used for comparison of categorical data between groups. A Spearman rank correlation analysis was also performed. ResultsAlanine aminotransferase (ALT), aspartate aminotransferase, LSM, controlled attenuation parameter (CAP), spleen length, and APRI gradually increased with the increase in BMI (all P＜0.05). The Spearman correlation analysis showed that LSM, ALT, BMI, and CAP were positively correlated with the degree of hepatic steatosis (r=0.263, 0.327, 0.184, and 0.452, all P＜0.05); LSM, ALT, and CAP were positively correlated with the degree of liver inflammation (r=0.357, 0.278, and 0.121, all P＜0.05); LSM, ALT, BMI, and CAP were positively correlated with the degree of liver fibrosis (r=0.500, 0.216, 0.248, and 0.101, all P＜0.05); age was negatively correlated with the degree of hepatic steatosis, liver inflammation, and liver fibrosis (r=-0.344, -0.129, and -0.163, all P＜0.05). ConclusionLSM, CAP, ALT, and age are significantly correlated with the degree of liver inflammation, liver fibrosis, and hepatic steatosis in NASH patients, and therefore, they can be used in noninvasive diagnostic and predictive models to access the severity of liver injury.

Objective:To evaluate correlation between left ventricular mechanical contraction synchrony and left ventricular systolic function by gated myocardial perfusion imaging(GMPI) using Cadmium-Zine-Telluride (CZT) SPECT.Methods:Three hundred and forty three consecutive patients( 232 males, 111 females, age (60.08±12.88) years) who underwent CZT SPECT GMPI in Shanxi Cardiovascular Hospital between January and August 2019 were retrospectively analyzed. The Emory cardiac toolbox was used to process the imaging data, and the left ventricular systolic synchrony parameters and systolic function parameters were acquired, including peak phase(PP), phase standard deviation (PSD), phase histogram bandwidth(PHB), histogram skewness(HS), histogram kurtosis(HK), and end-diastolic volume( EDV), end-systolic volume (ESV), left ventrieular ejection fraction (LVEF). All patients were divided into 4 groups: the normal group (147 cases), ischemic cardiomyopathy group (114 cases), nonischemic cardiomyopathy without left bundle branch block (LBBB) group(50 cases)and nonischemic cardiomyopathy with LBBB group(32 cases). The relationship between systolic synchrony parameters and systolic function parameters were analyzed with Pearson correlation analysis.Results:Statistic results for all patients showed that PSD and PHB were well correlated with LVEF( r values: -0.790, -0.799, both P<0.01), but PP was poorly correlated with LVEF( r=-0.194, P<0.01); HS, HK were positively correlated with LVEF( r values: 0.767, 0.676, both P<0.01); PSD, PHB were positively correlated with ESV( r values: 0.778, 0.795, both P<0.01) and EDV ( r values: 0.722, 0.732, both P<0.01); but PP was poorly correlated with ESV( r=0.145, P<0.01) and not correlated with EDV ( r=0.095, P>0.01). HS, HK were negatively correlated with EDV and ESV ( r values: -0.700 to -0.580, all P<0.01). PSD and PHB showed negatively correlation with LVEF ( r values: -0.834 to -0.492, all P<0.01), while HS, HK showed positive correlation with LVEF ( r values: 0.243-0.792, all P<0.01) in normal group, the ischemic cardiomyopathy group, the nonischemic cardiomyopathy without LBBB group and the nonischemic cardiomyopathy with LBBB group. Conclusions:The left ventricular systolic synchrony parameters provided by CZT SPECT GMPI correlate well with the left ventricular systolic function parameters, and the worse systolic function, the worse systolic synchrony. Both ischemic cardiomyopathy and non-ischemic cardiomyopathy can affect left ventricular mechanical contraction synchrony, and the effect on contraction synchrony in non-ischemic cardiomyopathy patients with LBBB is greater.