Diastolic Dysfunction in Liver Cirrhosis: Prognostic Predictor in Liver Transplantation?

Area of Science:

• Cardiology
• Hepatology
• Transplantation Medicine

Background:

• Liver cirrhosis can lead to cirrhotic cardiomyopathy (CC).
• CC is marked by impaired contractile response to stress, diastolic dysfunction (DD), and electrical abnormalities.
• These cardiac issues can negatively impact patient prognosis.

Purpose of the Study:

• To analyze the prevalence of diastolic dysfunction (DD) and prolonged QTc interval in patients with liver cirrhosis awaiting liver transplantation (LT).
• To investigate the correlation between these cardiac abnormalities and post-LT outcomes, including mortality.

Main Methods:

• Retrospective analysis of 106 patients undergoing LT between January 2012 and June 2015.
• Evaluation of demographic data, cirrhosis etiology, Child-Pugh and MELD scores, preoperative QTc interval, and cardiac function (systolic and diastolic).
• Statistical comparison of DD and QTc prolongation with MELD/Child-Pugh scores and post-LT outcomes using chi-square, Fisher, and Mann-Whitney U tests.

Main Results:

• The study included 106 patients (80.2% male, average age 54.83 years).
• Prevalence of prolonged QTc was 19% and DD was 35.8%.
• No significant association was found between QTc prolongation or DD and MELD or Child-Pugh scores.

Conclusions:

• A significant incidence of diastolic dysfunction (DD) was observed in patients pre-LT, indicating a predisposition to adverse cardiac events.
• The presence of DD is associated with increased mortality following liver transplantation in patients with hepatic cirrhosis.