Speckle tracking echocardiography enables the detection of subclinical left ventricular dysfunction at rest in many heart diseases and potentially in severe liver diseases. It could also possibly serve as a predictor for survival. In this study, 117 patients evaluated for liver transplantation in a single center between May 2010 and April 2016 with normal left ventricular ejection fraction were included according to clinical characteristics of their liver disease: (1) compensated ( = 29), (2) clinically significant portal hypertension ( = 49), and (3) decompensated ( = 39). Standard echocardiography and speckle tracking echocardiography were performed at rest and during dobutamine stress. Follow-up amounted to three years to evaluate survival and major cardiac events. Altogether 67% (78/117) of the patients were transplanted and 32% (31/96 patients) died during the three-year follow-up period. Global longitudinal strain (GLS) at rest was significantly increased (became more negative) with the severity of liver disease ( < 0.001), but reached comparable values in all groups during peak stress. Low (less negative) GLS values at rest (male: >-17/female: >-18%) could predict patient survival in a multivariate Cox regression analysis ( = 0.002). GLS proved valuable in identifying transplant candidates with latent systolic dysfunction.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464171PMC
http://dx.doi.org/10.3390/jcm9082616DOI Listing

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