Condition of intracardiac hemodynamics and microcirculation in patients with chronic ischemic heart disease and concomitant diffuse liver diseases

Abstract

Introduction. It is known that patients with ischemic heart diseases have endothelial dysfunction, but there is lack of research about microcirculation in these patients with diffuse liver diseases, especially diagnosed with digital capillaroscopy. Aim. To investigate hemodynamic disorders and microcirculation in patients with chronic ischemic heart disease depending on the presence of diffuse liver diseases and its severity with the digital capillaroscopy. Materials and methods. Our prospective study included 187 patients according to the criteria of inclusion. The data of echocardiography and digital capillaroscopy were analysed. Results. In our research in patients with ejection fraction less than 40% there was revealed thickening of the wall of the left ventricle, low blood supply in arterial and venous parts of capillaries. Patients with ejection fraction less than 40% and progressive diffuse liver diseases had advanced thickening of the wall of the left ventricle. Patients with liver cirrhosis had more adverse changes in hemodynamics. Patients with ischemic heart disease and diffuse liver disease had the worst capillary blood supply. Patients with ejection fraction less than 40% and diffuse liver diseases had structural changes of capillaries such as bi-, trifurcation and bushy forms. Conclusions. So, diffuse liver diseases, especially severe, cause endothelial dysfunction in patients with ischemic heart diseases. Digital capillaroscopy is a noninvasive method for microcirculation diagnosis and patients’ monitoring.