Measures of right ventricular systolic function in end stage liver disease patients awaiting transplant

López‐Candales, Angel; Menéndez, Francisco López; Shah, Shimul A.; Friedrich, Andrew D.

doi:10.1016/j.ijcard.2013.11.088

Cited by 6 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A previous post-mortem analysis revealed a high rate of RV chamber dilatation in approximately one-third of patients with cirrhosis [21]. Similar to the findings of the present study, others have demonstrated that patients with cirrhosis have a larger RV dimension than controls when measured by echocardiography [16,22,23]. In the present study, the RV dimension is significantly increased in patients with cirrhosis.…”

Section: Discussionsupporting

confidence: 91%

A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation

Chen

Chan

et al. 2016

Journal of Cardiology

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation

Chen

Chan

et al. 2016

Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…Other studies have evaluated RV function in ESLD patients while awaiting and during transplants [ 22 , 33 , 34 ]. A retrospective study compared TAPSE and TAs between a group of ESLD patients being considered for OLT and patients without the liver disease [ 22 ]. All patients included in the study had normal LV systolic function and normal pulmonary artery systolic pressures [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Two-dimensional (2D) transthoracic echocardiography is a routine examination for the assessment of porto-pulmonary hypertension [ 21 ], RV/LV structure and function [ 22 , 23 ], porto-pulmonary shunt [ 24 ] and the necessity of right heart catheterization among patients with ESLD being considered for liver transplantation. The association of RV functional impairment and advanced chronic liver disease in patients with porto-pulmonary hypertension has been well-established.…”

Section: Introductionmentioning

confidence: 99%

Isolated Subclinical Right Ventricle Systolic Dysfunction in Patients after Liver Transplantation

Güler

Omaygenç

Naki

et al. 2023

JCM

View full text Add to dashboard Cite

Although hemodynamic alterations in end-stage liver disease (ESLD) and its association with porto-pulmonary hypertension have been well-established, the long-term effects of ESLD on RV systolic function in patients without porto-pulmonary hypertension remain disregarded. Here we aimed to assess the long-term effect of ESLD on RV function and its relationship with the use of NSBBs and clinical, laboratory and imaging parameters in end-stage liver disease. The use of NSBBs is still controversial due to concerns about reduced cardiac contractility and the possibility of increased mortality. Thirty-four liver transplant recipients were included. Demographic characteristics, laboratory and baseline echocardiography measures were obtained. Patients were recalled for transthoracic echocardiographic evaluation after transplantation. Right ventricle dysfunction was identified by having at least one value below the reference levels of RV S’, or TAPSE. Isolated subclinical RV dysfunction was observed at 20.6% of the sample population. The present study demonstrates hemodynamic circulation in cirrhosis and increased preload and afterload might have long-term effects on RV function, even the lack of porto-pulmonary hypertension. These findings underline the significance of cardiac function follow-up in cirrhotic patients after transplantation. In this study, patients treated with propranolol seemed to have better RV function and less gastrointestinal bleeding. We speculated that preoperative propranolol treatment might help preserve RV function by providing RAS suppression, improving endothelial function and hyperdynamic circulation seen in ESLD. This potential protective relationship between the use of propranolol and RV function might improve mortality or graft-failure during OLT and after liver transplantation in patients with cirrhosis.

show abstract

“…One study reported similar values between cirrhotic and healthy individuals [35]. In contrast, two other studies [36,37] found that TAPSE was significantly higher among cirrhotic patients. If the latter data were considered, our patients' TAPSE and RVFAC baseline values would be interpreted as decreased.…”

Section: Plos Onementioning

confidence: 91%

Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography

et al. 2022

View full text Add to dashboard Cite

Background The pathophysiology of advanced liver cirrhosis may induce alterations in the circulatory system that may be challenging for the anesthesiologist to manage intraoperatively, and perioperative cardiovascular events are associated with worse outcomes in cirrhotic patients undergoing liver transplantation. It remains controversial whether right ventricular function is impaired during this procedure. Studies using transesophageal echocardiography for quantitative analysis of the right ventricle remain scarce in this setting, yielding conflicting results. The aim of this study was to perform a quantitative assessment of right ventricular function with two parameters derived from transesophageal echocardiography during liver transplantation. Methods Nineteen adult patients of both genders undergoing liver transplantation were evaluated in this observational study. The exclusion criteria were age under 18 or above 65 years old, fulminant hepatic failure, hepatopulmonary syndrome, portopulmonary hypertension, cardiopulmonary disease, and contraindications to the transesophageal echocardiogram. Right ventricular function was assessed at five stages during liver transplantation: baseline, hepatectomy, anhepatic, postreperfusion, and closure by measuring tricuspid annular plane systolic excursion and right ventricular fractional area change obtained with transesophageal echocardiography. Results Right ventricular function was found to be normal throughout the procedure. The tricuspid annular plane systolic excursion showed a trend toward a decrease in the anhepatic phase compared to baseline (2.0 ± 0.9 cm vs. 2.4 ± 0.7 cm; P = 0.24) but with full recovery after reperfusion. Right ventricular fractional area change remained nearly constant during all stages studied (minimum: 50% ± 10 at baseline and anhepatic phase; maximum: 56% ± 12 at postreperfusion; P = 0.24). Conclusions Right ventricular function was preserved during liver transplantation at the time points evaluated by two quantitative parameters derived from transesophageal echocardiogram.

show abstract

Measures of right ventricular systolic function in end stage liver disease patients awaiting transplant

Cited by 6 publications

References 10 publications

A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation

A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation

Isolated Subclinical Right Ventricle Systolic Dysfunction in Patients after Liver Transplantation

Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography

Contact Info

Product

Resources

About