The heart in liver transplantation

Ripoll, Cristina; Yotti, Raquel; Bermejo, Javier; Bañares, Rafael

doi:10.1016/j.jhep.2010.11.003

Cited by 85 publications

(58 citation statements)

References 166 publications

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“…Evidence suggests that the activity of the guanylate cyclase system is increased with worsening severity of liver failure [13]. This may explain the increased prevalence of adverse intraoperative cardiovascular events in patients who have a greater severity of illness due to liver disease [18].…”

Section: Discussionmentioning

confidence: 99%

The response to methylene blue in patients with severe hypotension during liver transplantation

Berman

Merritt

Hendrickse

et al. 2012

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

The response to methylene blue in patients with severe hypotension during liver transplantation

Berman

Merritt

Hendrickse

et al. 2012

Journal of Clinical Anesthesia

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“…Indeed, decompensated cirrhotics with a high degree of portal hypertension have a prolonged QT interval, due to electrolyte disturbances or the use of QT interval-prolonging drugs, that need correction [34]. Although, in normal hemodynamic conditions, echocardiography is an excellent tool to assess the presence of systolic or diastolic dysfunction, generally cirrhotics are affected by a hyperdynamic syndrome; this hemodynamic disturbance influences the cardiac load and makes an accurate evaluation of cardiac function through conventional echocardiography more difficult [34].…”

Section: Pre-transplant Investigative Methodsmentioning

confidence: 99%

“…Although, in normal hemodynamic conditions, echocardiography is an excellent tool to assess the presence of systolic or diastolic dysfunction, generally cirrhotics are affected by a hyperdynamic syndrome; this hemodynamic disturbance influences the cardiac load and makes an accurate evaluation of cardiac function through conventional echocardiography more difficult [34].…”

Section: Pre-transplant Investigative Methodsmentioning

confidence: 99%

Cirrhotic cardiomyopathy in the pre- and post-liver transplantation phase

Zardi

Chin

et al. 2016

Journal of Cardiology

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Patients with advanced liver cirrhosis may develop a clinical syndrome characterized by a blunted contractile responsiveness to stress and/or altered diastolic relaxation, called "cirrhotic cardiomyopathy." This syndrome, which is initially asymptomatic, is often misdiagnosed due to the presence of symptoms that characterize other disorders present in patients with advanced liver cirrhosis, such as exercise intolerance, fatigue, and dyspnea. Stress and other conditions such as liver transplantation and transjugular intrahepatic portosystemic shunt (TIPS) may unmask this syndrome. Liver transplantation in this group of patients results in a clinical improvement and can be a cure for the cardiomyopathy. However, post-transplant prognosis depends on the identification of cirrhotics with cardiomyopathy in the pre-transplant phase; an early diagnosis of cirrhotic cardiomyopathy in the pre-transplant phase may avoid an acute onset or worsening of cardiac failure after liver transplantation. Since a preserved left ventricular ejection fraction may mask the presence of cirrhotic cardiomyopathy, the use of newer noninvasive diagnostic techniques (i.e. tissue Doppler, myocardial strain) is necessary to identify cirrhotics with this syndrome, in the pre-transplant phase. A pre-transplant treatment of heart failure in cirrhotics with cardiomyopathy improves the quality of life in this phase and reduces the complications during and immediately after liver transplantation. Since specific therapies for cirrhotic cardiomyopathy are lacking, due to the absence of a clear understanding of the pathophysiology of the cardiomyopathy, further research in this field is required.

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“…[3][4][5][6][7] Cirrhotic cardiomyopathy becomes clinically apparent mostly after exposition to physical stress 4 and increases risk for fatal complications after liver transplantation or after implantation of a transjugular intrahepatic portosystemic shunt. 3,4,8,9 Recent studies provide evidence that hypertrophy of the left ventricle, left-atrial dilatation, and increased enddiastolic and end-systolic left-ventricular volume may be more frequent in patients with liver cirrhosis. 4,8,10 Most recently, a high prevalence of cardiac arrhythmia, for example, atrial fibrillation has been demonstrated.…”

mentioning

confidence: 99%