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Prevalence and outcome of diastolic dysfunction in liver transplantation recipients

Sarah Raevens, Michel De Pauw, Anja Geerts

    Acta Cardiologica
    |July 18, 2014
    PubMed

    Insights

    Cirrhotic cardiomyopathy affects 43% of liver transplant candidates, with diastolic dysfunction being common. While diastolic dysfunction itself doesn't significantly impact outcomes, tricuspid regurgitation severity predicts survival post-transplantation.

    Area of Science:

    • Cardiology
    • Hepatology
    • Transplantation Medicine

    Background:

    • Cirrhotic cardiomyopathy (CCMP) is a cardiac dysfunction in cirrhotic patients, characterized by systolic (SD) and diastolic dysfunction (DD).
    • Liver transplantation (LTx) can improve CCMP, but CCMP itself is a risk factor for LTx outcomes.
    • Understanding CCMP prevalence and predictors is crucial for managing LTx candidates.

    Purpose of the Study:

    • To determine the prevalence of diastolic dysfunction (DD) in liver transplant (LTx) candidates.
    • To compare post-transplantation outcomes between LTx candidates with and without DD.
    • To assess if tricuspid regurgitation (TR) predicts outcomes following LTx.

    Main Methods:

    • Retrospective evaluation of 173 LTx recipients.
    • Echocardiography used to diagnose SD (ejection fraction < 55%) and DD (E/A ratio < 1 or deceleration time > 200 msec).
    • Outcomes analyzed based on mortality and cardiovascular complications, comparing patients with and without DD.

    Main Results:

    • Diastolic dysfunction (DD) was diagnosed in 43% of patients; systolic dysfunction (SD) in 2%.
    • Patients with DD were significantly older.
    • No significant difference in post-transplantation outcomes was observed between patients with and without DD.
    • Moderate/severe tricuspid regurgitation (TR) was associated with worse short-term and long-term post-transplantation outcomes compared to no or mild TR.

    Conclusions:

    • The prevalence of SD and DD in this LTx candidate population was 2% and 43%, respectively.
    • Diastolic dysfunction (DD) did not appear to strongly affect post-transplantation outcomes.
    • Tricuspid regurgitation severity, assessed by echocardiography, is a significant predictor of survival after liver transplantation.
    Abstract

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