Cardiac Changes in Pancreonecrosis
Keywords:pancreonecrosis, echocardiography, systolic and diastolic function of the left ventricle
Syndrome of multiple-organ failure is one of the causes of fatal outcome in acute destructive pancreatitis. One of the manifestations of this syndrome is cardiovascular insufficiency. Modern echocardiography permits to evaluate all structures of heart and surrounding tissues and to estimate the functional state of heart.
Purpose. To study morphological and functional changes of heart in pancreonecrosis by complex ultrasonography.
Material and methods. With this purpose 19 patients with pancreonecrosis have been examined. Examination includes M-mode and B-mode ultrasonography, colour carting and impulse dopplerultrasonography.
Results and discussion. The different changes of heart in pancreonecrosis have been revealed: hydropericardium in 5 patients (26.32 %), increasing end-diastolic size and end-diastolic volume of left ventricle in 8 patients (42.1 %), increasing end-systolic size and end-systolic volume of left ventricle in 3 patients (15.79 %), hypertrophy of intraventricle septum in 4 patients (21.04 %). Hypertrophy of intraventricle septum was accompanied with increasing cavity of left atrium in 3 patients (15.78 %).
Regurgitation of blood from left ventricle to left atrium has been revealed in 6 patients (31.58 %) including patients with hypertrophy of intraventricle septum and increasing cavity of left atrium. Regurgitation of blood from right ventricle to right atrium has been revealed in 2 patients (10.52 %). Both types of regurgitation have been evaluated as functional (relative) ones because changes of mitral and tricuspid valves were absent.
Decreasing stroke volume and ejection fraction of left ventricle as a result of decreasing contractility of myocardium have been revealed in 2 patients (10.52 %) with hydropericardium. Decreasing contractility of myocardium has been revealed in all patients with increased end-diastolic and end-systolic volumes of left ventricle. Minute volume in those patients was normal due to compensatory tachycardia.
Conclusion. The different morphological and functional changes of heart in the patients with pancreonecrosis are revealed, thus diastolic function of the left ventricle is affected more frequently than systolic one.
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