https://doi.org/10.4081/monaldi.2024.2963
Clinical and echocardiographic predictors of outcome in liver transplant patients
Submitted: February 21, 2024
Accepted: April 9, 2024
Published: August 28, 2024
Accepted: April 9, 2024
Abstract Views: 272
PDF_EARLY VIEW: 26
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Liver transplant (LT) candidates undergo transthoracic echocardiography (TTE) before surgery to assess cardiac function and evaluate the echocardiographic probability of pulmonary hypertension (PHT). The improvement of pulmonary artery systolic pressure (PAPS) after transplant is associated with higher survival rates in patients with mild or moderate PHT. Although studies analyze the outcomes of LT in patients treated for PHT, the prognostic value of PAPS in patients without PHT in the follow-up is unknown. The aim of our study is to evaluate pre- and post-LT cardiac function, right ventricular function, pulmonary artery pressure, and their association with long-term mortality. 102 patients who underwent LT between 2011 and 2018 were compared for echocardiographic and hemodynamic parameters pre- and post-LT. After LT, systolic blood pressure, heart rate (HR), and PASP significantly increased, while tricuspid annular plane systolic excursion/PAPS decreased. Moreover, the higher difference in HR and PASP between pre- and post-LT was highlighted in those patients who died during the follow-up period after LT. Among all the parameters tested, in the multi-variable Cox regression for mortality, left ventricular ejection fraction and PASP difference were predictors of mortality. This study highlights the importance of TTE in LT screening as a tool to stratify patients at higher risk of death due to advanced cirrhotic cardiomyopathy and the importance of the change of echocardiographic parameters, in particular right and left ventricular hemodynamics, during the follow-up period. These parameters could be used to guide a more aggressive therapy.
Yoon KT, Liu H, Lee SS. Cirrhotic Cardiomyopathy. Curr Gastroenterol Rep 2020;22:45.
DOI: https://doi.org/10.1007/s11894-020-00783-1
Myers RP, Lee SS. Cirrhotic cardiomyopathy and liver transplantation. Liver Transpl 2000;6:S44-52.
DOI: https://doi.org/10.1002/lt.500060510
DuBrock HM, Runo JR, Sadd CJ, Burger CD, Cartin-Ceba R, Rosen CB, et al. Outcomes of liver transplantation in treated portopulmonary hypertension patients with a mean pulmonary arterial pressure ≥35 mm Hg. Transplant Direct 2020;6:e630.
DOI: https://doi.org/10.1097/TXD.0000000000001085
Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015;16:233-70. Erratum in: Eur Heart J Cardiovasc Imaging 2016;17:412. Corrigendum in: Eur Heart J Cardiovasc Imaging 2016;17:969.
DOI: https://doi.org/10.1093/ehjci/jew041
Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016;29:277-314.
DOI: https://doi.org/10.1016/j.echo.2016.01.011
Badano LP, Kolias TJ, Muraru D, et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 2018;19:591-600.
DOI: https://doi.org/10.1093/ehjci/jey042
Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
DOI: https://doi.org/10.1016/j.echo.2010.05.010
Vriz O, Pirisi M, Bossone E, et al. Right ventricular-pulmonary arterial uncoupling in mild-to-moderate systemic hypertension. J Hypertens 2020;38:274-81.
DOI: https://doi.org/10.1097/HJH.0000000000002238
Vriz O, Veldman G, Gargani L, et al. Age-changes in right ventricular function-pulmonary circulation coupling: from pediatric to adult stage in 1899 healthy subjects. The RIGHT Heart International NETwork (RIGHT-NET). Int J Cardiovasc Imaging 2021;37:3399-411.
DOI: https://doi.org/10.1007/s10554-021-02330-z
Todaro MC, Carerj S, Zito C, et al. Echocardiographic evaluation of right ventricular-arterial coupling in pulmonary hypertension. Am J Cardiovasc Dis 2020;10:272-83.
Liberal R, Grant CR, Baptista R, Macedo G. Porto-pulmonary hypertension: a comprehensive review. Clin Res Hepatol Gastroenterol 2015;39:157-67.
DOI: https://doi.org/10.1016/j.clinre.2014.12.011
Saleemi S. Portopulmonary hypertension. Ann Thorac Med 2010;5:5-9.
DOI: https://doi.org/10.4103/1817-1737.58953
Izzy M, VanWagner LB, Lin G, et al. Redefining cirrhotic cardiomyopathy for the modern era. Hepatology 2020;71:334-45.
DOI: https://doi.org/10.1002/hep.30875
Kwon HM, Jun IG, Jung KW, et al. Pretransplant Resting heart rate and its association with all-cause mortality in liver transplant recipients. Transplant Proc 2017;49:1092-6.
DOI: https://doi.org/10.1016/j.transproceed.2017.03.043
Humbert M, Kovacs G, Hoeper MM, 2022 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). Eur Heart J 2022;43:3618-731.
DOI: https://doi.org/10.1093/eurheartj/ehac237
Ethics Approval
This study was approved by the Ethical Committee of King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia (protocol number 2191217).How to Cite
Landi, Irene, Suliman Alharbil, Abdullah Alfehaid, Sarah Aldosari, Abdalla Eltayeb A.A, Nadiah Alruwaili, Roberto Troisi, Domenico Galzerano, Mario Pirisi, and Olga Vriz. 2024. “Clinical and Echocardiographic Predictors of Outcome in Liver Transplant Patients”. Monaldi Archives for Chest Disease, August. https://doi.org/10.4081/monaldi.2024.2963.
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