Diastolic dysfunction in patients with end-stage liver disease is associated with development of heart failure early after liver transplantation.
Transplantation
; 94(6): 646-51, 2012 Sep 27.
Article
in En
| MEDLINE
| ID: mdl-22918216
ABSTRACT
BACKGROUND:
Liver transplantation (LTx) is a life-saving treatment of end-stage liver disease. Cardiac complications including heart failure (HF) are among the leading causes of death after LTx. THEAIM:
The aim is to identify clinical and echocardiographic predictors of developing HF after LTx.METHODS:
Patients who underwent LTx at the University of Nebraska Medical Center (UNMC) between January 2001 and January 2009 and had echocardiographic study before and within 6 months after transplantation were identified. Patients with coronary artery disease (>70% lesion) were excluded. HF after LTx was defined by clinical signs, symptoms, radiographic evidence of pulmonary congestion, and echocardiographic evidence of left ventricular dysfunction (left ventricle ejection fraction <50%).RESULTS:
Among 107 patients (presented as mean age [SD], 55 [10] years; male, 70%) who met the inclusion criteria, 26 (24%) patients developed HF after LTx. The pre-LTx left ventricle ejection fraction did not differ between the HF (69 [7]) and the control groups (69 [7] vs. 67 [6], P=0.30). However, pre-LTx elevation of early mitral inflow velocity/mitral annular velocity (P=0.02), increased left atrial volume index (P=0.05), and lower mean arterial pressure (P=0.03) were predictors of HF after LTx in multivariate analysis. Early mitral inflow velocity/mitral annular velocity greater than 10 and left atrial volume index 40 mL/m2 or more were associated with a 3.4-fold (confidence interval, 1.2-9.4; P=0.017) and 2.9-fold (confidence interval, 1.1-7.5; P=0.03) increase in risk of development of HF after LTx, respectively.CONCLUSIONS:
This study suggests that elevated markers of diastolic dysfunction during pre-LTx echocardiographic evaluation are associated with an excess risk of HF and may predict post-LTx survival.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ventricular Function, Left
/
Liver Transplantation
/
Ventricular Dysfunction, Left
/
Diastole
/
Heart Failure
/
Kidney Failure, Chronic
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Country/Region as subject:
America do norte
Language:
En
Journal:
Transplantation
Year:
2012
Document type:
Article
Affiliation country:
United States