Background: Major adverse cardiac events (MACE) are a leading cause of morbidity and mortality after orthotopic liver transplantation (OLT). Cirrhotic cardiomyopathy (CCM), initially described in 2005 and revised in 2019, is a source of MACE in patients after OLT. We sought to identify CCM-related predictors of MACE at one-year follow-up after OLT and assess for reversibility of CCM post-OLT.
Methods: This is a retrospective study of adult patients who underwent OLT between 2009 and 2019. All patients had transthoracic echocardiography pre-and post-OLT. Patients with a left ventricular ejection fraction <50 % pre-OLT were excluded. MACE was defined as death, myocardial infarction, congestive heart failure hospitalization, or cardiac arrest.
Results: In total, 131 patients were included in this study, of whom 103 and 23 patients met the 2005 and 2019 criteria, respectively. During the follow-up period, 42 patients had MACE and these patients were more likely to have ascites (p = 0.003), hepatorenal syndrome (p = 0.019), and CCM per 2005 criteria (p = 0.023). There were no significant differences between pre-OLT CCM per 2019 criteria (19 % vs 17 %, p = 0.758) or MELD-Na score (21.24 vs 19.40, p = 0.166) for MACE post-OLT. Per the 2005 criteria, 35 of 103 patients recovered and these patients were less likely to have MACE post-OLT (p = 0.012). Per the 2019 criteria, 13 of 23 patients recovered post-OLT but this low number precluded further statistics.
Conclusion: The 2005 Montreal criteria for CCM were an independent predictor of MACE at one-year follow-up post-OLT while the 2019 CCC criteria for CCM were not. In addition, the 2005 Montreal criteria were more prevalent when compared to 2019 CCC criteria. Finally, the 2005 Montreal criteria were reversible post-OLT 34 % of the time compared to the 2019 CCC criteria which were reversible 57 % of the time.
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http://dx.doi.org/10.1016/j.jjcc.2023.04.007 | DOI Listing |
Am J Gastroenterol
November 2024
Division of Gastroenterology and Hepatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Introduction: Heart failure (HF) after transjugular intrahepatic portosystemic shunt (TIPS) placement affects up to 20% of patients. Understanding factors associated with post-TIPS HF is critical. Cirrhotic cardiomyopathy (CCM) is associated with adverse clinical outcomes.
View Article and Find Full Text PDFNat Sci Sleep
December 2024
Department of General Surgery, People's Hospital Affiliated to Jiangsu University, Zhenjiang, Jiangsu, 212002, People's Republic of China.
Objective: The main purpose of this study is to evaluate the changes in sleep quality among patients with cirrhotic cardiomyopathy (CCM).
Methods: The study included liver cirrhosis patients aged 18-75 from Northern Jiangsu People's Hospital Affiliated to Yangzhou University and collected their clinical examination results to assess the clinical characteristics and related risk factors of patients with CCM.
Results: The study found that the onset of CCM was not related to the etiology of inducing cirrhosis.
Mol Immunol
December 2024
Wuxi Medical Center, Nanjing Medical University, Wuxi, China; The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China; Wuxi People's Hospital, Wuxi, China. Electronic address:
In the context of liver cirrhosis, the incidence of myocardial inflammation and apoptosis escalates, contributing to the development and progression of cirrhotic cardiomyopathy. The P2X7 receptor, a purinergic receptor linked to inflammatory processes, has been identified in the etiology of a range of autoinflammatory, autoimmune, chronic inflammatory, and metabolic disorders. Despite this, the specific role of the P2X7 receptor in the etiology of cirrhotic cardiomyopathy remains to be elucidated.
View Article and Find Full Text PDFPediatr Cardiol
November 2024
Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Ave-R1, Bronx, NY, 10467, USA.
Cirrhotic cardiomyopathy is a complication of cirrhosis resulting in cardiac dysfunction. It remains poorly characterized in children. The aim of this study was to assess relationship of pre-liver transplant (LT) conventional and novel parameters of biventricular function with post-LT clinical course.
View Article and Find Full Text PDFJ Anesth Analg Crit Care
November 2024
Department of Anesthesia and ICU, San Camillo-Forlanini Hospital, Rome, Italy.
Cardiovascular complications are common in patients with severe liver disease and are an important cause of peri-operative and post-transplant morbidity and mortality. Cirrhotic cardiomyopathy (CCM), often found in advanced liver disease, is characterized by diastolic dysfunction, systolic dysfunction, and electrophysiological abnormalities. While CCM may not cause symptoms at rest, it can become evident during stressful activities, such as surgery.
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