Diastolic Dysfunction in Patients With End-Stage Liver Disease is Associated With Development of Heart Failure Early After Liver Transplantation
Liver transplantation (LTx) is a life-saving treatment of end-stage liver disease. Cardiac complications including heart failure (HF) are among the leading causes of death after LTx. The aim is to identify clinical and echocardiographic predictors of developing HF after LTx. Patients who underwent L...
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| Veröffentlicht in: | Transplantation 2012-09, Vol.94 (6), p.646-651 |
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| creator | DOWSLEY, Taylor F BAYNE, David B LANGNAS, Alan N DUMITRU, Ioana WINDLE, John R PORTER, Thomas R RAICHLIN, Eugenia |
| description | Liver transplantation (LTx) is a life-saving treatment of end-stage liver disease. Cardiac complications including heart failure (HF) are among the leading causes of death after LTx.
The aim is to identify clinical and echocardiographic predictors of developing HF after LTx.
Patients who underwent LTx at the University of Nebraska Medical Center (UNMC) between January 2001 and January 2009 and had echocardiographic study before and within 6 months after transplantation were identified. Patients with coronary artery disease (>70% lesion) were excluded. HF after LTx was defined by clinical signs, symptoms, radiographic evidence of pulmonary congestion, and echocardiographic evidence of left ventricular dysfunction (left ventricle ejection fraction |
| doi_str_mv | 10.1097/TP.0b013e31825f0f97 |
| format | Article |
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The aim is to identify clinical and echocardiographic predictors of developing HF after LTx.
Patients who underwent LTx at the University of Nebraska Medical Center (UNMC) between January 2001 and January 2009 and had echocardiographic study before and within 6 months after transplantation were identified. Patients with coronary artery disease (>70% lesion) were excluded. HF after LTx was defined by clinical signs, symptoms, radiographic evidence of pulmonary congestion, and echocardiographic evidence of left ventricular dysfunction (left ventricle ejection fraction <50%).
Among 107 patients (presented as mean age [SD], 55 [10] years; male, 70%) who met the inclusion criteria, 26 (24%) patients developed HF after LTx. The pre-LTx left ventricle ejection fraction did not differ between the HF (69 [7]) and the control groups (69 [7] vs. 67 [6], P=0.30). However, pre-LTx elevation of early mitral inflow velocity/mitral annular velocity (P=0.02), increased left atrial volume index (P=0.05), and lower mean arterial pressure (P=0.03) were predictors of HF after LTx in multivariate analysis. Early mitral inflow velocity/mitral annular velocity greater than 10 and left atrial volume index 40 mL/m2 or more were associated with a 3.4-fold (confidence interval, 1.2-9.4; P=0.017) and 2.9-fold (confidence interval, 1.1-7.5; P=0.03) increase in risk of development of HF after LTx, respectively.
This study suggests that elevated markers of diastolic dysfunction during pre-LTx echocardiographic evaluation are associated with an excess risk of HF and may predict post-LTx survival.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0b013e31825f0f97</identifier><identifier>PMID: 22918216</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Academic Medical Centers ; Age ; Aged ; Arterial Pressure ; Biological and medical sciences ; Blood pressure ; Cardiology. Vascular system ; Case-Control Studies ; Diastole ; Echocardiography, Doppler ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Heart ; Heart Atria - diagnostic imaging ; Heart Atria - physiopathology ; Heart diseases ; Heart Failure - diagnostic imaging ; Heart Failure - etiology ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart transplantation ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - surgery ; Linear Models ; Liver diseases ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver Transplantation - mortality ; Lung ; Male ; Medical sciences ; Middle Aged ; Mitral Valve - diagnostic imaging ; Mitral Valve - physiopathology ; Multivariate Analysis ; Nebraska ; Predictive Value of Tests ; Risk Assessment ; Risk Factors ; Stroke Volume ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survival ; Time Factors ; Tissue, organ and graft immunology ; Treatment Outcome ; Ventricle ; Ventricular Dysfunction, Left - complications ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - mortality ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Function, Left</subject><ispartof>Transplantation, 2012-09, Vol.94 (6), p.646-651</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c413t-51914e5d25d86126e00a2a77394ef467a3dbd48fd89d7455787ad3102fe1422a3</citedby><cites>FETCH-LOGICAL-c413t-51914e5d25d86126e00a2a77394ef467a3dbd48fd89d7455787ad3102fe1422a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26399467$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22918216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DOWSLEY, Taylor F</creatorcontrib><creatorcontrib>BAYNE, David B</creatorcontrib><creatorcontrib>LANGNAS, Alan N</creatorcontrib><creatorcontrib>DUMITRU, Ioana</creatorcontrib><creatorcontrib>WINDLE, John R</creatorcontrib><creatorcontrib>PORTER, Thomas R</creatorcontrib><creatorcontrib>RAICHLIN, Eugenia</creatorcontrib><title>Diastolic Dysfunction in Patients With End-Stage Liver Disease is Associated With Development of Heart Failure Early After Liver Transplantation</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Liver transplantation (LTx) is a life-saving treatment of end-stage liver disease. Cardiac complications including heart failure (HF) are among the leading causes of death after LTx.
The aim is to identify clinical and echocardiographic predictors of developing HF after LTx.
Patients who underwent LTx at the University of Nebraska Medical Center (UNMC) between January 2001 and January 2009 and had echocardiographic study before and within 6 months after transplantation were identified. Patients with coronary artery disease (>70% lesion) were excluded. HF after LTx was defined by clinical signs, symptoms, radiographic evidence of pulmonary congestion, and echocardiographic evidence of left ventricular dysfunction (left ventricle ejection fraction <50%).
Among 107 patients (presented as mean age [SD], 55 [10] years; male, 70%) who met the inclusion criteria, 26 (24%) patients developed HF after LTx. The pre-LTx left ventricle ejection fraction did not differ between the HF (69 [7]) and the control groups (69 [7] vs. 67 [6], P=0.30). However, pre-LTx elevation of early mitral inflow velocity/mitral annular velocity (P=0.02), increased left atrial volume index (P=0.05), and lower mean arterial pressure (P=0.03) were predictors of HF after LTx in multivariate analysis. Early mitral inflow velocity/mitral annular velocity greater than 10 and left atrial volume index 40 mL/m2 or more were associated with a 3.4-fold (confidence interval, 1.2-9.4; P=0.017) and 2.9-fold (confidence interval, 1.1-7.5; P=0.03) increase in risk of development of HF after LTx, respectively.
This study suggests that elevated markers of diastolic dysfunction during pre-LTx echocardiographic evaluation are associated with an excess risk of HF and may predict post-LTx survival.</description><subject>Academic Medical Centers</subject><subject>Age</subject><subject>Aged</subject><subject>Arterial Pressure</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>Diastole</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Heart</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - physiopathology</subject><subject>Heart diseases</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart transplantation</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Linear Models</subject><subject>Liver diseases</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver Transplantation - mortality</subject><subject>Lung</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - physiopathology</subject><subject>Multivariate Analysis</subject><subject>Nebraska</subject><subject>Predictive Value of Tests</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Survival</subject><subject>Time Factors</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><subject>Ventricular Dysfunction, Left - complications</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - mortality</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Function, Left</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU-LE0EQxRtR3Lj6CQTpi7CXWfvv9MwxbLLuQsCAEY9DZbpaWyYzsauzkG_hR7aXRIW9eKrL771XVY-xt1JcS9G6D5v1tdgKqVHLRtkgQuuesZm02lS1aMRzNhPCyEpq7S7YK6IfQgirnXvJLpRqi0bWM_ZrEYHyNMSeL44UDmOf4zTyOPI15IhjJv415u98Ofrqc4ZvyFfxARNfREIg5JH4nGjqI2T0J3SBDzhM-10R8ynwO4SU-S3E4ZCQLyENRz4PuXicnDYJRtoPMGZ4jH7NXgQYCN-c5yX7crvc3NxVq08f72_mq6o3UufKylYatF5Z39RS1SgEKHBOtwaDqR1ov_WmCb5pvTPWusaB11KogNIoBfqSXZ1892n6eUDK3S5Sj0NZBKcDdVKrpoRoaf6PirpVwlmrC6pPaJ8mooSh26e4g3QsUPfYWrdZd09bK6p354DDdof-r-ZPTQV4fwaAehhCeVkf6R9X67YtR-vf50uhHg</recordid><startdate>20120927</startdate><enddate>20120927</enddate><creator>DOWSLEY, Taylor F</creator><creator>BAYNE, David B</creator><creator>LANGNAS, Alan N</creator><creator>DUMITRU, Ioana</creator><creator>WINDLE, John R</creator><creator>PORTER, Thomas R</creator><creator>RAICHLIN, Eugenia</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20120927</creationdate><title>Diastolic Dysfunction in Patients With End-Stage Liver Disease is Associated With Development of Heart Failure Early After Liver Transplantation</title><author>DOWSLEY, Taylor F ; BAYNE, David B ; LANGNAS, Alan N ; DUMITRU, Ioana ; WINDLE, John R ; PORTER, Thomas R ; RAICHLIN, Eugenia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c413t-51914e5d25d86126e00a2a77394ef467a3dbd48fd89d7455787ad3102fe1422a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Academic Medical Centers</topic><topic>Age</topic><topic>Aged</topic><topic>Arterial Pressure</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>Diastole</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Heart</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - physiopathology</topic><topic>Heart diseases</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart transplantation</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Linear Models</topic><topic>Liver diseases</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver Transplantation - mortality</topic><topic>Lung</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - physiopathology</topic><topic>Multivariate Analysis</topic><topic>Nebraska</topic><topic>Predictive Value of Tests</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Survival</topic><topic>Time Factors</topic><topic>Tissue, organ and graft immunology</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><topic>Ventricular Dysfunction, Left - complications</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - mortality</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DOWSLEY, Taylor F</creatorcontrib><creatorcontrib>BAYNE, David B</creatorcontrib><creatorcontrib>LANGNAS, Alan N</creatorcontrib><creatorcontrib>DUMITRU, Ioana</creatorcontrib><creatorcontrib>WINDLE, John R</creatorcontrib><creatorcontrib>PORTER, Thomas R</creatorcontrib><creatorcontrib>RAICHLIN, Eugenia</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DOWSLEY, Taylor F</au><au>BAYNE, David B</au><au>LANGNAS, Alan N</au><au>DUMITRU, Ioana</au><au>WINDLE, John R</au><au>PORTER, Thomas R</au><au>RAICHLIN, Eugenia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diastolic Dysfunction in Patients With End-Stage Liver Disease is Associated With Development of Heart Failure Early After Liver Transplantation</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2012-09-27</date><risdate>2012</risdate><volume>94</volume><issue>6</issue><spage>646</spage><epage>651</epage><pages>646-651</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Liver transplantation (LTx) is a life-saving treatment of end-stage liver disease. Cardiac complications including heart failure (HF) are among the leading causes of death after LTx.
The aim is to identify clinical and echocardiographic predictors of developing HF after LTx.
Patients who underwent LTx at the University of Nebraska Medical Center (UNMC) between January 2001 and January 2009 and had echocardiographic study before and within 6 months after transplantation were identified. Patients with coronary artery disease (>70% lesion) were excluded. HF after LTx was defined by clinical signs, symptoms, radiographic evidence of pulmonary congestion, and echocardiographic evidence of left ventricular dysfunction (left ventricle ejection fraction <50%).
Among 107 patients (presented as mean age [SD], 55 [10] years; male, 70%) who met the inclusion criteria, 26 (24%) patients developed HF after LTx. The pre-LTx left ventricle ejection fraction did not differ between the HF (69 [7]) and the control groups (69 [7] vs. 67 [6], P=0.30). However, pre-LTx elevation of early mitral inflow velocity/mitral annular velocity (P=0.02), increased left atrial volume index (P=0.05), and lower mean arterial pressure (P=0.03) were predictors of HF after LTx in multivariate analysis. Early mitral inflow velocity/mitral annular velocity greater than 10 and left atrial volume index 40 mL/m2 or more were associated with a 3.4-fold (confidence interval, 1.2-9.4; P=0.017) and 2.9-fold (confidence interval, 1.1-7.5; P=0.03) increase in risk of development of HF after LTx, respectively.
This study suggests that elevated markers of diastolic dysfunction during pre-LTx echocardiographic evaluation are associated with an excess risk of HF and may predict post-LTx survival.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22918216</pmid><doi>10.1097/TP.0b013e31825f0f97</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplantation, 2012-09, Vol.94 (6), p.646-651 |
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| subjects | Academic Medical Centers Age Aged Arterial Pressure Biological and medical sciences Blood pressure Cardiology. Vascular system Case-Control Studies Diastole Echocardiography, Doppler Female Fundamental and applied biological sciences. Psychology Fundamental immunology Heart Heart Atria - diagnostic imaging Heart Atria - physiopathology Heart diseases Heart Failure - diagnostic imaging Heart Failure - etiology Heart Failure - mortality Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart transplantation Humans Kaplan-Meier Estimate Kidney Failure, Chronic - complications Kidney Failure, Chronic - mortality Kidney Failure, Chronic - surgery Linear Models Liver diseases Liver transplantation Liver Transplantation - adverse effects Liver Transplantation - mortality Lung Male Medical sciences Middle Aged Mitral Valve - diagnostic imaging Mitral Valve - physiopathology Multivariate Analysis Nebraska Predictive Value of Tests Risk Assessment Risk Factors Stroke Volume Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Survival Time Factors Tissue, organ and graft immunology Treatment Outcome Ventricle Ventricular Dysfunction, Left - complications Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - mortality Ventricular Dysfunction, Left - physiopathology Ventricular Function, Left |
| title | Diastolic Dysfunction in Patients With End-Stage Liver Disease is Associated With Development of Heart Failure Early After Liver Transplantation |
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