1.Cardiac structure and function in patients with viral, alcoholic or biliary cirrhosis: A comparative study
Journal of Clinical Hepatology 2026;42(6):1321-1326
ObjectiveTo investigate the potential differences in cardiac lesions between the patients with viral, alcoholic or biliary cirrhosis. MethodsA retrospective analysis was performed for the clinical data of 512 patients who were hospitalized in Hunan Provincial People’s Hospital due to liver cirrhosis from January 2020 to December 2023, and according to the etiology, the patients were divided into viral cirrhosis group with 275 patients, alcoholic cirrhosis group with 70 patients, and biliary cirrhosis group with 167 patients. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test or the Tamhane’s T2 test was used based on homogeneity of variance for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between groups. ResultsThere was a significant difference in sex distribution between the three groups, and the male patients accounted for 71.3% in the viral cirrhosis group and 95.7% in the alcoholic cirrhosis group, while the female patients accounted for 64.7% in the biliary cirrhosis group. The biliary cirrhosis group had an age of 61.67±9.59 years, which was significantly higher than that in the other two groups (P<0.05). Compared with the viral cirrhosis group and the biliary cirrhosis group, the alcoholic cirrhosis group had significantly higher Child-Pugh score (H=30.598, P<0.05), globulin (H=13.350, P<0.05), and QTc interval (F=9.956, P<0.05) and significantly lower hemoglobin (F=4.529, P<0.05), prothrombin activity (F=36.293, P<0.05), and albumin (F=15.744, P<0.05). There were no significant differences in each echocardiography parameter between the viral cirrhosis group and the alcoholic cirrhosis group (P>0.05); compared with the biliary cirrhosis group, the viral cirrhosis group and the alcoholic cirrhosis group had significantly larger left atrial anterior-posterior diameter (H=19.197, P<0.05), left ventricular end-diastolic diameter (LVEDD) (H=15.660, P<0.05), right atrial transverse diameter (H=22.854, P<0.05), mid-right ventricular transverse diameter (H=10.936, P<0.05), interventricular septal thickness in diastole (IVSd) (H=13.539, P<0.05), and left ventricular posterior wall thickness in diastole (LVPWd) (H=14.139, P<0.05); compared with the biliary cirrhosis group, the viral cirrhosis group had a significantly higher mitral ratio of peak early to late diastolic filling velocity (E/A) (P<0.05). Left ventricular diastolic dysfunction was observed in 170 patients (61.8%) in the viral cirrhosis group, 45 patients (64.3%) in the alcoholic cirrhosis group, and 125 patients (74.9%) in the biliary cirrhosis group, with a significant difference between the three groups (χ2=8.074, P=0.018). The patients were divided into grade A, B, and C groups based on Child-Pugh score, and comparisons of echocardiography findings between the three groups showed no significant differences in LVEDD, IVSd, LVPWd, E/A, and left ventricular ejection fraction (all P>0.05). ConclusionThere are differences in cardiac structure and function between patients with different etiologies of liver cirrhosis, and in clinical practice, individualized cardiac assessment and intervention should be performed based on different etiologies.
2.Cardiac lesion characteristics in patients with liver cirrhosis and their correlation with esophageal varices
Journal of Clinical Hepatology 2026;42(7):1607-1613
ObjectiveTo investigate the characteristics of cardiac structure and function in patients with liver cirrhosis and the correlation of cardiac ultrasound parameters and cardiac function parameters with esophageal varices (EV), and to provide a theoretical basis for identifying high-risk patients in the early stage, optimizing clinical management, and improving prognosis. MethodsA retrospective analysis was performed for the clinical data of 359 patients who were hospitalized in Hunan Provincial People’s Hospital and were diagnosed with liver cirrhosis from January 2020 to December 2023, among whom there were 176 patients in the non-EV group and 183 patients in the EV group. The two groups were compared in terms of general data, laboratory test results, and examination findings, and the characteristics of cardiac lesions were analyzed for liver cirrhosis patients with EV. The independent samples t-test was used for comparison between the two groups, a one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test or the Tamhane’s T2 test was used for further comparison between two groups based on homogeneity of variance; The Mann-Whitney U test was used for comparison between the two groups, the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between groups; the Spearman’s rank correlation coefficient was used for correlation analysis. ResultsThere were no significant differences in sex and age between the two groups (all P >0.05). Compared with the non-EV group, the EV group had significantly lower levels of red blood cell, hemoglobin, platelet, prothrombin activity, albumin, and albumin/globulin ratio (all P<0.05) and significantly higher values of total bilirubin, total bile acid, cardiac creatine kinase, fibrosis-4 index, LOK index, aspartate aminotransferase-to-platelet ratio index, and aspartate aminotransferase-to-alanine aminotransferase ratio (all P <0.001). For the non-EV group, 58.0% of the patients had Child-Pugh class A disease, while in the EV group, 48.1% of the patients had Child-Pugh class B disease. Compared with the non-EV group, the EV group had significantly greater left atrial anterior-posterior diameter (LA-ap), left ventricular end-diastolic diameter (LVEDD), right atrial transverse diameter (RA-t), early diastolic filling velocity at the mitral valve orifice (E), early diastolic filling velocity/late diastolic filling velocity (E/A) ratio, peak systolic velocity of pulmonary valve (PV), peak systolic velocity of aortic valve (AV), and QTc interval (all P<0.05). The Spearman correlation analysis showed that LA-ap, LVEDD, RA-t, E, E/A, PV, AV and QTc interval were positively correlated with EV (all P<0.05), among which LA-ap, E, and PV had an r-value of 0.297, 0.223, and 0.311, respectively. Comparison of the patients with different Child-Pugh classes showed that compared with the Child-Pugh class B and C groups, the Child-Pugh class A group had significantly smaller LA-ap, mid-right ventricular transverse diameter, E, PV, AV, HR, and QTc interval (all P<0.05); compared with the Child-Pugh class B group, the Child-Pugh class A group had significantly lower values of LVEDD, RA-t, and E/A ratio (all P<0.05); there were significant differences in A and PV between the Child-Pugh class B group and the Child-Pugh class C group (all P<0.05). ConclusionLiver cirrhosis patients with EV have significant cardiac lesions, and routine echocardiography should be performed to assess cardiac function.

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