Myocardial Performance after Successful Liver Transplantation

Area of Science:

• Cardiology
• Pediatric Gastroenterology
• Transplant Surgery

Background:

• The Myocardial Performance Index (MPI), or Tei index, is a Doppler-derived measure of combined systolic and diastolic myocardial function.
• It is calculated using isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), and ejection time (ET).

Purpose of the Study:

• To assess right and left ventricular systolic and diastolic function using MPI in pediatric liver transplant recipients.
• To compare cardiac function before and after liver transplantation.

Main Methods:

• A cross-sectional study involved 30 children with liver cirrhosis pre-transplant, 30 post-transplant (≥6 months), and 30 controls.
• Echocardiography with Tissue Doppler Imaging (TDI) was used to evaluate MPI in both ventricles.

Main Results:

• Right ventricular MPI was significantly higher in cirrhotic patients compared to controls (p<0.001) and remained elevated post-transplant (p=0.031).
• Left ventricular MPI showed a significant correlation with Child-Turcotte-Pugh (CTP) score (r=0.57, p=0.03).
• No significant differences in left ventricular MPI were observed between pre-transplant, post-transplant, and control groups.

Conclusions:

• Right ventricular MPI is impaired in children with liver cirrhosis and does not recover within six months of liver transplantation.
• Left ventricular MPI is associated with the severity of liver disease as indicated by the CTP score.