Diagnostic Criteria of Cirrhotic Cardiomyopathy

Liu, Hongqun; Lee, Samuel S.

doi:10.1002/hep.32021

Cited by 12 publications

(9 citation statements)

References 9 publications

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“…This may reflect progressive stiffness of the myocardium and deteriorating cardiac function (22). Prior studies have revealed association of E/A, E/e', and LAVI with poor survival post-LT (17, [23][24][25][26]; however, it is not well-suited to apply the E/A ratio owing to its load-and age-dependence (27,28). In comparison, some previous studies have failed to find any relevance (4,29).…”

Section: Discussionmentioning

confidence: 99%

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

Jiang²,

Zhao³

et al. 2023

Front. Surg.

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BackgroundDiastolic dysfunction (DD), one of the earliest signs of cirrhotic cardiomyopathy (CCM), is included in the revised 2019 CCM criteria. Nonetheless, relevant research regarding the effects of revised DD on post-liver transplantation (LT) outcomes remains limited.MethodsThis retrospective study enrolled patients who underwent LT for decompensated cirrhosis, from January 2018 to March 2021. Patients were divided into DD and non-DD groups. Clinical data were collected. Patients were followed up with, for at least 1 year post-LT; cardiovascular adverse events (AEs) and survival status were recorded. Risk factors were identified using 1:2 propensity score matching (PSM), after adjusting for confounding factors. The caliper value was set to 0.02.ResultsOf 231 patients, 153 were diagnosed with DD (male, 81.8%; mean age, 51.5 ± 9.5 years). Nineteen patients with DD died within 1 year, post-LT. After PSM, 97 and 60 patients were diagnosed with and without DD, respectively. Patients with DD had longer intensive care unit (ICU) stays, higher perioperative cardiovascular AEs, and higher mortality rates than those without DD. In a multivariate analysis, interventricular septum (IVS), left atrial volume index (LAVI), and potassium levels were independent prognostic factors of perioperative cardiovascular AEs, while a decreased early diastolic mitral annular tissue velocity (e’), increased neutrophil-to-lymphocyte ratio (NLR) and tumor markers were predictors of mortality within 1 year post-LT after PSM (P < 0.05).ConclusionCardiac DD may contribute to perioperative cardiovascular AEs and mortality post-LT. Clinicians should be aware of decompensated cirrhosis in patients with DD.

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Section: Discussionmentioning

confidence: 99%

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

Jiang²,

Zhao³

et al. 2023

Front. Surg.

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“…Dentro del análisis de regresión en árbol (CART), los datos importantes relacionados con mortalidad y disfunción del injerto son IMC bajos, con corte en nuestro estudio < 19, incluso relacionado o no con terapia de reemplazo renal, datos indicativos indirectos de sarcopenia, ya que se muestra que el 30%-70% de los cirróticos padecen en la última clasificación del CCC, con hallazgos de FEVI < 50% y disminución de la GLS > 18%, con la valoración cuidadosa del componente diastólico teniendo en cuenta las múltiples variables que pueden afectar la precarga, con base en anormalidades electromecánicas como la prolongación del QT (8) .…”

Section: Probabilidad De Mortalidadunclassified

“…La cardiomiopatía cirrótica es una entidad sin criterios diagnósticos aún establecidos, pero la definición con mejor aceptación es la del Cirrhotic Cardiomyopathy Consortium (2019), la cual se conforma de variables como las alteraciones sistólicas/diastólicas, apoyado en la valoración de la deformación longitudinal global (GLS) y alteraciones electrocardiográficas como es la prolongación del QT (7,8) . Este síndrome, que usualmente no es reconocido en la fase inicial, sino en su descompensación, en los últimos años ha tomado importancia como predictor en su alteración de desenlaces como insuficiencia cardíaca, lesión renal e incluso pérdidas del injerto a corto y largo plazo (3,(9)(10)(11) .…”

Section: Introductionunclassified

Variables hemodinámicas cardíacas y desenlaces postrasplante hepático en un centro de referencia de trasplantes en Colombia a 2600 metros sobre el nivel del mar

Montalvo¹,

Rueda

Rojas

et al. 2022

Rev. colomb. Gastroenterol.

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Introducción: la valoración hemodinámica mediante ecocardiografía Doppler tiene importancia en la identificación de alteraciones sistólicas/diastólicas como predictor de desenlaces en el postrasplante hepático desde alteraciones cardiovasculares hasta disfunción del injerto y mortalidad. Métodos: estudio de cohorte retrospectivo. Paciente con trasplante hepático en el hospital LaCardio, en Bogotá, Colombia entre enero de 2005 y julio de 2021. Análisis de variables sociodemográficas, comorbilidades, ecocardiografía y variables intraoperatorias con desenlaces primarios como disfunción temprana del injerto, lesión renal aguda (LRA) y mortalidad durante el seguimiento. Se realizó un árbol de clasificación y regresión (CART). Resultados: se analizaron a 397 pacientes, el 54,4% eran hombres, y el 71% tenía algún grado de disfunción diastólica, hipertrofia ventricular izquierda (30,9%) con presencia de disfunción del injerto en el 8% y LRA en el 21%, y una mortalidad del 15% durante el seguimiento del estudio. En el modelo CART para desenlaces de mortalidad y disfunción del injerto se relacionó con la presencia de índice de masa corporal (IMC) < 19 o la combinación de IMC entre 19 y < 24 con diálisis. Conclusión: las variables ecocardiográficas, la sarcopenia y la LRA o requerimiento de terapia de reemplazo renal se relacionan con desenlaces de mortalidad y disfunción del injerto.

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“…In Asian populations, chronic viral hepatitis B is the primary cause of liver cirrhosis ( 1 ). Cirrhotic cardiomyopathy (CCM) is one of the significant complications of cirrhosis and is closely related to the poor prognosis of patients with liver cirrhosis ( 2 ). It comprises a triad of impaired myocardial contractile responses to stress (systolic dysfunction), inadequate ventricular relaxation (diastolic dysfunction), and electrophysiological abnormalities in the absence of any known cardiac disease ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Correlation analysis between myocardial work indices and liver function classification in patients with hepatitis B cirrhosis: A study with non-invasive left ventricular pressure-strain loop

Cao

Zhang²,

Li³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundLiver cirrhosis is closely associated with cardiac dysfunction. The aims of this study were to evaluate left ventricular systolic function in patients with hepatitis B cirrhosis by non-invasive left ventricular pressure-strain loop (LVPSL) technique, and to explore the correlation between myocardial work indices and liver function classification.MethodsAccording to the Child-Pugh classification, 90 patients with hepatitis B cirrhosis were further divided into three groups: Child-Pugh A group (n = 32), Child-Pugh B group (n = 31), and Child-Pugh C group (n = 27). During the same period, 30 healthy volunteers were recruited as the control (CON) group. Myocardial work parameters, which included global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were derived from the LVPSL and compared among the four groups. The correlation between myocardial work parameters and Child-Pugh liver function classification was evaluated, and the independent risk factors affecting left ventricular myocardial work in patients with cirrhosis were investigated by univariable and multivariable linear regression analysis.ResultsGWI, GCW and GWE of Child-Pugh B and C groups were lower than those of CON group, while GWW was higher than that of CON group, and the changes were more obvious in Child-Pugh C group (P < 0.05). Correlation analysis revealed that GWI, GCW, and GWE were negatively correlated with liver function classification to various degrees (r = −0.54, −0.57, and −0.83, respectively, all P < 0.001), while GWW was positively correlated with liver function classification (r = 0.76, P < 0.001). Multivariable linear regression analysis showed that GWE was positively correlated with ALB (β = 0.17, P < 0.001), and negatively correlated with GLS (β = −0.24, P < 0.001).ConclusionsThe changes in the left ventricular systolic function in patients with hepatitis B cirrhosis were identified using non-invasive LVPSL technology, and myocardial work parameters are significantly correlated with liver function classification. This technique may provide a new method for the evaluation of cardiac function in patients with cirrhosis.

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Diagnostic Criteria of Cirrhotic Cardiomyopathy

Cited by 12 publications

References 9 publications

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis

Variables hemodinámicas cardíacas y desenlaces postrasplante hepático en un centro de referencia de trasplantes en Colombia a 2600 metros sobre el nivel del mar

Correlation analysis between myocardial work indices and liver function classification in patients with hepatitis B cirrhosis: A study with non-invasive left ventricular pressure-strain loop

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