Open AccessEvaluation of Cardiac Function by Tissue Doppler Imaging in Children With Chronic Hepatitis
Author(s) -
Bora Polat Tugcin,
Urganci Nafiye,
Yalcin Yalim,
Akdeniz Celal,
Zeybek Cenap,
Erdem Abdullah,
Celebi Ahmet
Publication year - 2006
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/01.mpg.0000228101.12326.6f
Subject(s) - medicine , cardiology , subclinical infection , cirrhosis , diastole , isovolumic relaxation time , tissue doppler echocardiography , ventricle , fibrosis , myocardial fibrosis , doppler imaging , siderosis , doppler echocardiography , gastroenterology , diastolic function , blood pressure
Objectives: Pathoanatomic changes in cirrhosis result in impaired ventricular filling and diastolic dysfunction and were named as cirrhotic cardiomyopathy. However, cardiac functions have not been studied in patients with chronic hepatitis. We hypothesized that such patients might have subclinical ventricular dysfunction, detectable by tissue Doppler echocardiography and related to the severity of hepatic inflammation and fibrosis. Methods: We studied 63 clinically stable patients, 27 patients with mild chronic hepatitis (group 1), 22 patients with moderate chronic hepatitis (group 2) and 14 patients with severe chronic hepatitis (group 3) according to the scoring system of Knodell, and 36 age‐matched healthy subjects. Results: Patients with severe chronic hepatitis had impaired right ventricular diastolic function. The early diastolic velocity of the tricuspid valve annulus was lower in patients from group 3 than in healthy subjects ( P < 0.001). Patients in group 3 had a greater isovolumic relaxation time ( P < 0.001), indicating right ventricular diastolic dysfunction. Comparing group 3 with the healthy subjects, the ratio of peak early myocardial tissue velocity and peak late (or atrial) myocardial tissue velocity was significantly decreased ( P < 0.001), at 1.4 (0.7) and 1.9 (0.7), respectively. There was also a slightly lower peak early myocardial tissue velocity and peak late (or atrial) myocardial tissue velocity ratio and a slightly longer isovolumic relaxation time in patients from group 2 than in healthy subjects ( P < 0.05). Conclusions: We detected subclinical dysfunction of the right ventricle in children with chronic hepatitis in whom hepatic inflammation and fibrosis is prominent. Tissue Doppler echocardiography provides a quantifiable indicator useful for detection and monitoring of disease progression.