Impact of Cirrhotic Cardiomyopathy Diagnosed According to Different Criteria on Patients with Cirrhosis Awaiting Liver Transplantation: A Retrospective Cohort Study

Singh, Achintya D.; Ford, Andrew M.; Lyu, Ruishen; Layoun, Habib; Harb, Serge C.; Fares, Maan; Carey, William D.

doi:10.1007/s10620-022-07412-z

Cited by 10 publications

(24 citation statements)

References 29 publications

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“…Previous studies showed discrepancy concerning the prevalence of advanced LVDD (range from 10.5% to 33.3%), [39][40][41] but always higher, compared to our study. Nevertheless, the present study is a prospective study that includes all consecutive stable patients presenting with ESLD in our center, which is one of the largest transplant centers in our country, while the three previous studies are retrospective [39][40][41] with a possible selection bias of the included patients.…”

Section: Discussioncontrasting

confidence: 99%

“…Nevertheless, only one study provided data regarding this issue, showing that advanced diastolic dysfunction was associated with higher pre-LT mortality rates. 40 Finally, in our study, it was found that CCM was not associated with the severity of cirrhosis, as both CTP and MELD scores did not differ between patients with and without CCM (p = 0.74 and 0.51, respectively). This finding is in agreement with the results of previous studies.…”

Section: Discussionsupporting

confidence: 43%

“…In the literature only very few studies 39–41 have used the newly proposed CCC criteria for evaluation of CCM 5 . All these studies were retrospective ( Table 7 ) .…”

Section: Discussionmentioning

confidence: 99%

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Left atrial strain and ventricular global longitudinal strain in cirrhotic patients using the new criteria of Cirrhotic Cardiomyopathy Consortium

Skouloudi,

Bonou,

Adamantou

et al. 2023

Liver International

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BackgroundThe new criteria of Cirrhotic Cardiomyopathy Consortium (CCC) propose the use of left ventricular global longitudinal strain (LV‐GLS) for evaluation of systolic function in patients with cirrhosis. The aim of this study was to evaluate LV‐GLS and left atrial (LA) strain in association with the severity of liver disease and to assess the characteristics of cirrhotic cardiomyopathy (CCM).MethodsOne hundred and thirty‐five cirrhotic patients were included. Standard echocardiography and speckle tracking echocardiography (2D‐STE) were performed, and dual X‐ray absorptiometry was used to quantify the total and regional fat mass. CCM was defined, based on the criteria of CCC, as having advanced diastolic dysfunction, left ventricular ejection fraction ≤50% and/or a GLS <18%.ResultsLV‐GLS lower or higher than the absolute mean value (22.7%) was not associated with mortality (logrank, p = 0.96). LV‐GLS was higher in patients with Model for end stage liver disease (MELD) score ≥15 compared to MELD score <15 (p = 0.004). MELD score was the only factor independently associated with systolic function (LV‐GLS <22.7% vs. ≥22.7%) (Odds Ratio:1.141, p = 0.032). Patients with CCM (n = 11) had higher values of estimated volume of visceral adipose tissue compared with patients without CCM (median: 735 vs. 641 cm3, p = 0.039). On multivariable Cox regression analysis, MELD score [Hazard Ratio (HR):1.26, p < 0.001] and LA reservoir strain (HR:0.96, p = 0.017) were the only factors independently associated with the outcome.ConclusionIn our study, absolute LV‐GLS was higher in more severe liver disease, and LA reservoir strain was significantly associated with the outcome in patients with end‐stage liver disease.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 43%

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Left atrial strain and ventricular global longitudinal strain in cirrhotic patients using the new criteria of Cirrhotic Cardiomyopathy Consortium

Skouloudi,

Bonou,

Adamantou

et al. 2023

Liver International

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“…Cardiac dysfunction in LT candidates including CCM has garnered significant interest recently due to its association with HRS and posttransplant cardiovascular morbidity and mortality. [20][21][22] In this study cardiac dysfunction was frequently observed in LT candidates and was associated with HRS/AKI before LT. Although it was significantly associated with peri-and post-operative morbidity, it was reassuring that it did not predispose to increased mortality before and after LT.…”

Section: Discussionmentioning

confidence: 65%

“…Cardiac dysfunction in LT candidates including CCM has garnered significant interest recently due to its association with HRS and post‐transplant cardiovascular morbidity and mortality 20–22 . In this study cardiac dysfunction was frequently observed in LT candidates and was associated with HRS/AKI before LT.…”

Section: Discussionmentioning

confidence: 74%

Impact of cardiac dysfunction on morbidity and mortality in liver transplant candidates

Mohammadi

Ramachandran

Woodman

et al. 2022

Clinical Transplantation

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The prognostic role of cardiac dysfunction in cirrhotic patients is increasingly recognized. We studied its impact on morbidity and mortality before and after liver transplantation (LT) including development of post-transplant cardiovascular disease (CVD).In this retrospective study, cirrhotic patients who underwent LT assessment from January 2010 to December 2020 were reviewed. Demographics, cardiac investigations and clinical courses were analyzed to identify the prevalence of cardiac dysfunction and its role in LT outcomes. Survival analysis was performed using Cox proportional hazard regression modelling, with LT as a time-varying covariate and as an interaction variable with cardiac dysfunction. Three hundred and eight patients (70% male) were studied. The median (interquartile range) age at LT assessment was 56 (12) years. Cardiac dysfunction was found in 178 (58%) patients (diastolic, 169; systolic, 26; both, 17) and was significantly associated with hepatorenal syndrome/acute kidney injury and peri-and post-transplant morbidity (adjusted odds ratio [aOR] 1.94, 95% CI 1.06-3.52, P < .001; aOR 2.01, 95% CI 1.06-3.82, P = .033; aOR 1.9, 95% CI 1.01-3.65, P = .023, respectively). Cardiac dysfunction was not associated with mortality before (adjusted hazard ratio [aHR] 1.01, 95% CI .99-1.01) or after LT (aHR .74, 95% CI .4-1.05. Posttransplant CVD (61% cardiac failure) occurred in 36 patients, and there was no significant association with cardiac dysfunction (P = .11). Cardiac dysfunction was common in LT candidates and was significantly associated with morbidity before and after LT.Studies on the role of advanced echocardiographic parameters to improve diagnosis of cardiac dysfunction and optimize LT outcomes are needed.

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Analyzing the Different Prevalence for Cirrhotic Cardiomyopathy in Different Studies

Izzy

VanWagner

2022

Dig Dis Sci

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Impact of Cirrhotic Cardiomyopathy Diagnosed According to Different Criteria on Patients with Cirrhosis Awaiting Liver Transplantation: A Retrospective Cohort Study

Cited by 10 publications

References 29 publications

Left atrial strain and ventricular global longitudinal strain in cirrhotic patients using the new criteria of Cirrhotic Cardiomyopathy Consortium

Left atrial strain and ventricular global longitudinal strain in cirrhotic patients using the new criteria of Cirrhotic Cardiomyopathy Consortium

Impact of cardiac dysfunction on morbidity and mortality in liver transplant candidates

Analyzing the Different Prevalence for Cirrhotic Cardiomyopathy in Different Studies

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