Stress-Induced Cardiomyopathy (Takotsubo Cardiomyopathy) After Liver Transplantation—Report of Two Cases

Pires, Lucas José Tachotti; Curiati, Milena Novaes Cardoso; Reiche, F.; Silvestre, Odílson Marcos; Mangini, Sandrigo; Afonso, R.C.; Ferraz-Neto, Ben Hur; Bacal, Fernando

doi:10.1016/j.transproceed.2012.07.037

Cited by 49 publications

(17 citation statements)

References 9 publications

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“…Seven patients had echocardiographic findings of apical ballooning typically found on stress cardiomyopathy (Takotsubo cardiomyopathy). Previous reports have described this stress‐induced cardiomyopathy after LT in patients who have a high MELD score . It is possible that this cardiomyopathy could be a different presentation of a latent cirrhotic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 82%

“…Median time to onset was 2 days post-transplant (range, 0-20). Echocardiograms showed global left ventricular hypokinesis and a decrease in ejection fraction (EF) from a median of 65% (range, 50-81) pretransplant to a median of 21% (range, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Median raw model for end-stage liver disease (MELD) score was 29 in patients with NIC vs. 18 in patients without cardiomyopathy (P = 0.01).…”

Section: Introductionmentioning

confidence: 99%

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Reversible non‐ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: a single‐centre experience

Yataco

Difato

Bargehr

et al. 2014

Liver International

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Reversible non‐ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: a single‐centre experience

Yataco

Difato

Bargehr

et al. 2014

Liver International

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“…There is sparse literature on the clinical course and reversibility of systolic HF after OLT. While majority of case reports published on systolic HF after OLT report complete recovery of left ventricular systolic function, some report nonrecovery or death . In a prospective evaluation of 754 patients having OLT, Sampathkumar et al report 100% recovery in left ventricular function in seven patients who developed systolic HF after OLT.…”

Section: Discussionmentioning

confidence: 99%

Systolic heart failure after liver transplantation: Incidence, predictors, and outcome

Sonny

Govindarajan

Jaber

et al. 2018

Clinical Transplantation

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Although most patients presenting for liver transplantation have normal left ventricular function, some develop left ventricular failure after transplantation. The primary objective of our study was to determine the predictors of systolic heart failure (HF) occurring immediately after liver transplantation. Its etiology, prospects of recovery, and factors associated with nonrecovery were also studied. Liver transplantations performed at our institution from January 2006 to February 2015 were evaluated using prospectively collected institutional registries. Patients with echocardiographically documented decline in ejection fraction to <45% within 6 months after liver transplantation were identified. Four controls were chosen per case: matched for age, gender, transplant year, and model for end-stage liver disease score. Conditional multivariable logistic regression was used for primary analysis and nonparametric tests for comparison between groups. In a cohort of 1284 adult patients, 45 cases and 180 controls were identified. Diastolic dysfunction (DD) was an independent predictor (OR 5.26, 95% CI 1.03-28.57, P = .04) of systolic HF in multivariable analysis. Stress-induced cardiomyopathy was the most common etiology. Left ventricular function recovered in 21 patients. Pretransplant DD decreased the chances of recovery (P = .05). In conclusion, patients with pretransplant DD need close post-transplant follow-up for timely identification of HF.

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“…In the following year, Tiwari [7] described a similar case. In 2012, Pires [8] described the course of the disease in 2 young patients who manifested cardiogenic shock secondary to severe left ventricular dysfunction, followed by complete recovery of ventricular function in the early period after the LT.…”

Section: Discussionmentioning

confidence: 99%

Postoperative left ventricular apical ballooning: Transient Takotsubo cardiomyopathy following orthotopic liver transplantation

2013

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Patient: Female, 51Final Diagnosis: Takotsubo cardiomyopathySymptoms: —Medication: —Clinical Procedure: —Specialty: Cardiology • TransplantologyObjective:Rare diseaseBackground:Left ventricular apical ballooning syndrome (LVAB), also known as Takotsubo cardiomyopathy, is a cardiac syndrome characterized by transient left ventricular dysfunction in the absence of obstructive atherosclerotic coronary artery disease. An episode of emotional stress, typically in female patients, is believed to precede and trigger the development of this syndrome.Case Report:We report a case of Takotsubo cardiomyopathy that developed after orthotopic liver transplantation in a 51-year-old woman. On D2 (day 2) the patient had severe hemodynamic compromise. Echocardiography showed systolic dysfunction of the left ventricle (LV), with ejection fraction (EF) of 20% and anteroapical akinesis and ballooning of the apical 2/3 of the LV. Troponin T was elevated but other markers of myocardial necrosis were negative, as was coronary angiography. From D7 onward, there was an improvement in the hemodynamics in conjunction with a gradual increase of LV EF. The patient was dismissed from the hospital on D30 with signs of normal cardiac function and LV motion and EF of 50%. Liver function was also excellent.Conclusions:Every major operation, including liver transplantation, is associated with emotional stress for the patient. Therefore, it is necessary to consider Takotsubo cardiomyopathy in the differential diagnosis of heart failure developing early after LT, and clinicians should subsequently use adequate diagnostic and therapeutic measures.

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Stress-Induced Cardiomyopathy (Takotsubo Cardiomyopathy) After Liver Transplantation—Report of Two Cases

Cited by 49 publications

References 9 publications

Reversible non‐ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: a single‐centre experience

Reversible non‐ischaemic cardiomyopathy and left ventricular dysfunction after liver transplantation: a single‐centre experience

Systolic heart failure after liver transplantation: Incidence, predictors, and outcome

Postoperative left ventricular apical ballooning: Transient Takotsubo cardiomyopathy following orthotopic liver transplantation

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