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CRITERIA FOR DIAGNOSIS OF CARDIOMYOPATHY IN PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS BEFORE THE ONSET OF HEART DAMAGE CLINICAL SIGNS.
Georgian Medical News 2020 March
The article clarifies the diagnostic criteria for syntropic heart damage - cardiomyopathy in patients with Alcoholic Liver Cirrhosis before the clinical signs of heart damage appear. As a result of the examination of 64 patients with Cirrhotic Cardiomyopathy, of which 51 patients were identified without clinical signs of heart damage (study group 1), 13 patients with clinical signsof heart damage (study group 2), and 23 patients without cardiomyopathy (comparison group), it was found that: 1) in patients with Cirrhotic Cardiomyopathy (both with and without manifestation of clinical signs of heart damage), there is a violation of its diastolic and systolic functions, which can be diagnosed by change of parameters of the natriuretic peptide in the blood plasma, the frequency of supraventricular premature beats and premature ventricular contractions, the duration of the QT interval, the maximum blood flow velocity in the phase of early filling of the left ventricle and the left atrium systole, their ratio, the myocardial functional capacity index, end-diastolic and end-systolic volumes of the left ventricle and left atrium; 2) in patients with Cirrhotic Cardiomyopathy without clinical manifestations, significantly lower (p<0.05) indicators of the natriuretic peptide, the frequency ofextrasystoles, the end-diastolic and end-systolic volumes of the left ventricle and left atrium, and a higher rate of ejection fraction of the left ventricle were revealed than in patients with the clinical manifestation of this disease; 3) we found high accuracy, specificity and sensitivity of the indicators of the natriuretic peptide, the QT interval (maximum, maximum corrected, average, mid-corrected), maximum blood flow velocity in the phase of early filling of the left ventricle and of the systole of the left atrium, their ratio, as well as the myocardial functional capacity index in patients with alcoholic liver cirrhosis with an asymptomatic course of cardiomyopathy that allows to use them to verify the diagnosis of Cirrhotic Cardiomyopathy until the first clinical signs of myocardial damage appear.
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