Comparison of Preoperative and Postoperative Conventional and Speckle Tracking Echocardiographic Parameters in Living
Gulsum Bingol1,2, Fulya Avci Demir3, Özge Özden4
1Cardiology, Arel University Medical Faculty, Istanbul, TUR.
Insights
Partial hepatectomy in living liver donors did not significantly impair ventricular or left atrial function, with only minor changes in specific echocardiographic parameters observed post-surgery.
Area of Science:
- Cardiology
- Transplant Surgery
- Medical Imaging
Background:
- Living liver donation involves partial hepatectomy, a major surgical procedure.
- Assessing cardiac function in donors post-donation is crucial for safety.
- Echocardiography, including strain imaging, is a key tool for evaluating cardiac performance.
Purpose of the Study:
- To evaluate the impact of partial hepatectomy on echocardiographic parameters in living liver donors.
- To assess changes in conventional and speckle tracking echocardiography metrics in the early postoperative period.
- To determine if liver donation surgery leads to deterioration of cardiac function.
Main Methods:
- Retrospective study of 90 living liver donors.
- Echocardiography performed before and 5-7 days after partial hepatectomy.
- Analysis included M-mode, 2D, tissue Doppler, and strain imaging (GLS, LAS).
Main Results:
- No significant changes in left ventricular (LV) or right ventricular (RV) global longitudinal strain (GLS).
- Left atrial strain (LAS) showed no change in reservoir (LAS-r) or conduit (LAS-cd) phases, but atrial contraction (LAS-ct) increased.
- Isovolumic relaxation time (IVRT) and E/A ratio decreased postoperatively.
Conclusions:
- Partial hepatectomy in living liver donors did not result in significant deterioration of ventricular or left atrial function.
- Minor postoperative alterations in IVRT and E/A ratio were observed.
- This study is the first to report on echocardiographic cardiac function changes after liver donation surgery.
Abstract:
Introduction We aimed to assess whether partial hepatectomy has an influence on conventional and speckle tracking parameters on echocardiography in living liver donors in the early postoperative period. Methods This study was a retrospective study to investigate the cardiac effects of liver donation after the transplant operation in a high-volume liver transplant center. Ninety living liver donors were included in the study. The echocardiographic images were obtained from 90 living liver donors before and five to seven days after the operation. The echocardiographic examinations were evaluated with a Philips Epiq 7 ultrasound system (Philips Ultrasound; Bothell, WA, USA) by experienced cardiologists in accordance with the recommendations of the American Society of Echocardiography. These included M-mode, two-dimensional imaging, tissue Doppler assessment at the septal and lateral mitral annulus, and strain imaging in all patients at rest in the left decubitus position. The changes in echocardiographic parameters in living liver donors were analyzed. Paired T-test was used to assess significant differences. Results The left ventricular (LV) global longitudinal strain (GLS), right ventricular (RV) GLS, and RV free wall LS, reservoir phase of left atrial strain (LAS-r), conduit phase of LAS (LAS-cd) did not show significant changes after the operation (for all, p>0.05). However, the absolute atrial contraction phase of LAS (LAS-ct) mean value increased significantly (14.2±8.8 vs 16.6±8.3, p=0.025) postoperatively. Among the conventional echo parameters, isovolumic relaxation time (IVRT) and the E/A ratio demonstrated notable postoperative alterations. The mean IVRT (87.3 ± 22.4 vs. 80.8 ± 18.1, p=0.014) and E/A ratio (1.5 ± 0.5 vs. 1.3 ± 0.3, p=0.012) exhibited a postoperative decline. Conclusions To the best of our knowledge, our study is the first to evaluate the effect of partial hepatectomy on cardiac functions by echocardiography in living liver donors, and there was no deterioration in the functions of both the ventricles and left atrium.
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