中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 42 Issue 7
Jul.  2026
Turn off MathJax
Article Contents

Cardiac lesion characteristics in patients with liver cirrhosis and their correlation with esophageal varices

DOI: 10.12449/JCH260717
Research funding:

Hunan Provincial Natural Science Foundation (2026JJ82562);

Key Guided Research Project of Hunan Provincial Health Commission (C202303018917)

More Information
  • Corresponding author: Fan Yongmei, fanyongmei@126.com (ORCID: 0000-0003-1234-1067)
  • Received Date: 2026-01-15
  • Accepted Date: 2026-03-18
  • Published Date: 2026-07-25
  •   Objective  To 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.  Methods  A 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.  Results  There 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).  Conclusion  Liver cirrhosis patients with EV have significant cardiac lesions, and routine echocardiography should be performed to assess cardiac function.

     

  • loading
  • [1]
    Chinese Society of Hepatology, Chinese Society of Gastroenterology, Chinese Society of Digestive Endoscopology of Chinese Medical Association. Guidelines on the management of esophagogastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol, 2023, 39( 3): 527- 538. DOI: 10.3760/cmaj.cn501113-20220824-00436.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会消化内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2023, 39( 3): 527- 538. DOI: 10.3760/cmaj.cn501113-20220824-00436.
    [2]
    Ginès P, Krag A, Abraldes J G, et al. Liver cirrhosis[J]. Lancet, 2021, 398( 10308): 1359- 1376. DOI: 10.1016/S0140-6736(21)01374-X.
    [3]
    Wiese S, Hove J D, Møller S. Cardiac imaging in patients with chronic liver disease[J]. Clin Physiol Funct Imaging, 2017, 37( 4): 347- 356. DOI: 10.1111/cpf.12311.
    [4]
    Razpotnik M, Bota S, Wimmer P, et al. The prevalence of cirrhotic cardiomyopathy according to different diagnostic criteria[J]. Liver Int, 2021, 41( 5): 1058- 1069. DOI: 10.1111/liv.14769.
    [5]
    Møller S, Henriksen J H. Cardiovascular complications of cirrhosis[J]. Gut, 2008, 57( 2): 268- 278. DOI: 10.1136/gut.2006.112177.
    [6]
    Chinese Society of Hepatology, Chinese Medical Associationl. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.

    中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
    [7]
    Zeng Wei, Hu Wencong, Zhang Xiaolong, et al. Risk factors for acute myocardial damage in patients with hepatitis B cirrhosis complicated by esophageal and gastric variceal bleeding[J]. J Pract Hepatol, 2017, 20( 4): 435- 438. DOI: 10.3969/j.issn.1672-5069.2017.04.014.

    曾伟, 胡文聪, 张小龙, 等. 乙型肝炎肝硬化食管胃底曲张静脉破裂出血患者合并急性心肌损伤危险因素分析[J]. 实用肝脏病杂志, 2017, 20( 4): 435- 438. DOI: 10.3969/j.issn.1672-5069.2017.04.014.
    [8]
    Chinese Society of Spleen and Portal Hypertension Surgery, Chinese Society of Surgery, Chinese Medical Association. Expert consensus on the diagnosis and treatment of esophageal and gastric variceal rupture bleeding in cirrhotic portal hypertension(2025 edition)[J]. Chin J Dig Surg, 2025, 24( 3): 271- 280. DOI: 10.3760/cma.j.cn115610-20241228-00590.

    中华医学会外科学分会脾及门静脉高压外科学组. 肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2025版)[J]. 中华消化外科杂志, 2025, 24( 3): 271- 280. DOI: 10.3760/cma.j.cn115610-20241228-00590.
    [9]
    Qian Yuxin, Du Mingshu, Zhang Pei. Efficacy evaluation of liver stiffness measurement, spleen thickness and splenic vein diameter in predicting esophageal varices in patients with hepatitis B cirrhosis[J]. Chin Hepatol, 2024, 29( 12): 1517- 1520. DOI: 10.3969/j.issn.1008-1704.2024.12.022.

    钱玉鑫, 杜明澍, 张培. 肝脏硬度值、脾脏厚度及脾静脉直径预测乙型肝炎肝硬化患者食管静脉曲张的效能评价[J]. 肝脏, 2024, 29( 12): 1517- 1520. DOI: 10.3969/j.issn.1008-1704.2024.12.022.
    [10]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of ascites and complications in cirrhosis[J]. J Clin Hepatol, 2017, 33( 10): 1847- 1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003.

    中华医学会肝病学分会. 肝硬化腹水及相关并发症的诊疗指南[J]. 临床肝胆病杂志, 2017, 33( 10): 1847- 1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003.
    [11]
    Deng H, Qi X S, Guo X Z. Diagnostic accuracy of APRI, AAR, FIB-4, FI, king, lok, forns, and FibroIndex scores in predicting the presence of esophageal varices in liver cirrhosis: A systematic review and meta-analysis[J]. Medicine, 2015, 94( 42): e1795. DOI: 10.1097/MD.0000000000001795.
    [12]
    Kong Y J, Xie L L, Chen T T, et al. Cardiac geometry in cirrhosis: Translation to public health and trial design[J]. Liver Int, 2025, 45( 8): e70209. DOI: 10.1111/liv.70209.
    [13]
    Batra S, Machicao V I, Bynon J S, et al. The impact of left ventricular hypertrophy on survival in candidates for liver transplantation[J]. Liver Transpl, 2014, 20( 6): 705- 712. DOI: 10.1002/lt.23875.
    [14]
    Wroński J, Fiedor P, Kwolczak M, et al. Retrospective analysis of liver cirrhosis influence on heart walls thickness[J]. Pathol Res Pract, 2015, 211( 2): 145- 149. DOI: 10.1016/j.prp.2014.10.012.
    [15]
    Costa M G, Chiarandini P, Della Rocca G. Hemodynamics during liver transplantation[J]. Transplant Proc, 2007, 39( 6): 1871- 1873. DOI: 10.1016/j.transproceed.2007.05.002.
    [16]
    Merli M, Calicchia A, Ruffa A, et al. Cardiac dysfunction in cirrhosis is not associated with the severity of liver disease[J]. Eur J Intern Med, 2013, 24( 2): 172- 176. DOI: 10.1016/j.ejim.2012.08.007.
    [17]
    Dourakis S P, Geladari E, Geladari C, et al. Cirrhotic cardiomyopathy: The interplay between liver and cardiac muscle. How does the cardiovascular system react when the liver is diseased?[J]. Curr Cardiol Rev, 2021, 17( 1): 78- 84. DOI: 10.2174/1573403X15666190509084519.
    [18]
    Giuseppe F, Graziella P, Tania T, et al. Cardiovascular dysfunction in patients with liver cirrhosis[J]. Ann Gastroenterol, 2015, 28( 1): 31- 40.
    [19]
    Zhang Liang, Hong Linwei. Consistency of evaluating left ventricular diastolic function using left atrial volume index and left atrial anteroposterior diameter[J]. J China Med Univ, 2024, 53( 9): 798- 803, 808. DOI: 10.12007/j.issn.0258-4646.2024.09.006.

    张亮, 洪林巍. 左心房容积指数与左心房前后径评价左心室舒张功能的一致性[J]. 中国医科大学学报, 2024, 53( 9): 798- 803, 808. DOI: 10.12007/j.issn.0258-4646.2024.09.006.
    [20]
    Huang Saifeng. Analysis of ultrasonic parameters of left ventricular diastolic function in 2146 cases[D]. Fuzhou: Fujian Medical University, 2018. DOI: 10.7666/d.D01580715.

    黄赛凤. 2146例左室舒张功能超声参数分析[D]. 福州: 福建医科大学, 2018. DOI: 10.7666/d.D01580715.
    [21]
    Li Guishen, Liu Nannan, Wang Zulu, et al. Evaluation of the effect of multimodal ultrasound on the dynamic changes of left atrial structure and function after catheter ablation in patients with paroxysmal atrial fibrillation[J]. Chin J Med Offic, 2025, 53( 6): 578- 581. DOI: 10.16680/j.1671-3826.2025.06.07.

    李贵申, 刘楠楠, 王祖禄, 等. 多模态超声对阵发性心房颤动患者导管消融术后左心房结构与功能动态变化效果评估[J]. 临床军医杂志, 2025, 53( 6): 578- 581. DOI: 10.16680/j.1671-3826.2025.06.07.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Article Metrics

    Article views (68) PDF downloads(17) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return