Cardiac remodelling identified by cardiovascular magnetic resonance in patients with hepatitis C infection and liver disease

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• 作者：Phillip J. Ngu ; Michelle Butler ; Alan Pham…
• 关键词：Myocardial fibrosis ; Hepatitis C ; Liver disease ; T1 time ; Diastolic dysfunction
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：32
• 期：4
• 页码：629-636
• 全文大小：630 KB
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• 作者单位：Phillip J. Ngu (1) (2)
  Michelle Butler (1) (2)
  Alan Pham (3)
  Stuart K. Roberts (4)
  Andrew J. Taylor (1) (2)
  
  1. Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia
  2. Baker IDI Heart and Diabetes Institute, Heart Centre, Alfred Hospital, 55 Commercial Road, Melbourne, 3004, Australia
  3. Department of Anatomical Pathology, Alfred Hospital, Melbourne, Australia
  4. Department of Gastroenterology, Alfred Hospital, Melbourne, Australia
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743

文摘

Chronic cardiac dysfunction in patients with chronic liver disease (CLD) in the absence of alcohol consumption or other cardiac disease is well described. Whilst functional and morphological features of this condition remain unclear, diastolic dysfunction has been implicated by echocardiography. We aimed to evaluate myocardial structure, function and tissue composition with cardiac magnetic resonance (CMR) imaging in patients with hepatitis C and histological evidence of liver disease on biopsy. Contrast-enhanced CMR imaging for morphological, functional and tissue characterization was performed on 16 patients with CLD and 21 healthy controls. Cardiac structure and function was assessed with standard cine imaging, with Late Gadolinium Enhancement (LGE) and myocardial T1 mapping (pre- and post-contrast) performed to evaluate regional and diffuse myocardial fibrosis respectively. Compared to controls, patients with CLD demonstrated lower left ventricular end-diastolic volume (LVEDV) (138 ± 36 vs. 167 ± 44 mL, p < 0.05), reduced stroke volume (88 ± 20 vs. 109 ± 29 mL, p = 0.016), lower post-contrast myocardial T1 time and higher Partition Coefficient consistent with diffuse myocardial fibrosis (466 ± 78 vs. 545 ± 134 ms and 0.247 ± 0.110 vs. 0.123 ± 0.057 %, p < 0.05 for both). There were no differences in other cardiac parameters including left ventricular mass and ejection fraction (p = NS for all comparisons). No patients in either group had evidence of LGE. Compared to controls, patients with hepatitis C and histological evidence liver involvement have lower LVEDV, SV and increased diffuse myocardial fibrosis, all of which are associated with diastolic dysfunction. LVEF and LV mass were preserved. This may explain in part previous functional observations made by echocardiography.