[Features of structural and functional changes of the myocardium in patients with chronic viral hepatitis].

OBJECTIVE

Our aim was to evaluate the characteristics of structural and functional changes of the heart in patients with chronic viral hepatitis.

METHODS

The study included 123 patients - 17 patients with aviraemnia after antiviral therapy (group 1), 38 patients with laboratory inactive hepatitis (group 2), 68 patients with biochemical active hepatitis (group 3). All patients had standard echocardiography, Doppler sonography and tissue Doppler echocardiography.

RESULTS

Patients with chronic viral hepatitis were revealed to develop changes in the geometry of the left ventricle (increase in the wall thickness). Patients with active hepatitis had increase in the left atrium, the right ventricle and indexed left ventricular mass of the heart. Significant morphological changes were not confirmed statistically in patients after "therapy". Pulmonary hypertension was revealed in 19% of cases, mitral valve prolapse was confirmed in 48%, with the detection rates being not dependent on hepatitis activity. Abnormal left ventricular remodeling was identified in 45% of patients, in patients with active hepatitis more frequently. Compliance dysfunction of both right and left ventricles was detected, it depends on the activity of the inflammatory process in the liver. This disorder partially persists after antiviral treatment.

CONCLUSION

Specifics of the structural and functional changes of the heart in patients with chronic viral hepatitis is the development of left ventricular hypertrophy, and in the presence of laboratory activity hepatitis - relative dilatation of the right heart and ventricular diastolic dysfunction of the heart. Carrying out specific antiviral therapy has a beneficial effect on cardiac hemodynamics parameters. Method of tissue Doppler echocardiography was efficient in evaluation of early disorders of diastolic function in patients with chronic viral hepatitis.