Echocardiography in the Liver Transplant Patient

Kakar, Parul; Gubitosa, James; Gerula, Christine

doi:10.1007/s11886-021-01531-1

Curr Cardiol Rep

2021

DOI: 10.1007/s11886-021-01531-1

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Echocardiography in the Liver Transplant Patient

Parul Kakar

James Gubitosa

Christine Gerula

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2024

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Cited by 2 publications

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Subclinical cardiac dysfunction detected by speckle-tracking echocardiography in patients with liver cirrhosis undergoing liver transplantation

Thu,

Hai,

et al. 2024

Egypt Liver Journal

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Background Cirrhosis is associated with chronic cardiovascular dysfunction termed cirrhotic cardiomyopathy (CCM), characterized by myocardial hypertrophy and diastolic dysfunction. Detecting early cardiac changes is crucial, especially in patients undergoing liver transplantation. Objective: This study aims to evaluate left ventricular systolic function in cirrhotic patients undergoing liver transplantation using speckle-tracking echocardiography. Methods A prospective observational study was conducted involving 54 cirrhotic patients who underwent liver transplantation, along with 28 age- and sex-matched healthy controls. Echocardiography, including conventional and two-dimensional speckle tracking echocardiography (2D-STE), was performed at baseline and one-month post-transplantation. Results The mean age in the cirrhotic group was 52.2 ± 12.7 years, with no significant difference compared to the control group. Viral hepatitis was the predominant etiology of cirrhosis (68.6%). Conventional echocardiography did not reveal significant differences between groups in LV ejection fraction [62% (56–69) vs. 59% (56–62); p = 0.830]. However, in cirrhotic patients, 2D-STE demonstrated significantly lower LV global longitudinal strain (LV-GLS) [17.5 (15.5–19.1) vs 19.0 (18.0–19.7), p = 0.006]. Post-transplantation, conventional echocardiography indices remained unchanged, while 2D-STE showed remarkable improvement in LV function, with increased LV-GLS compared to pre-transplantation value. Conclusions 2D-STE is a valuable tool for detecting and monitoring left ventricular systolic dysfunction in liver cirrhosis patients, particularly following transplantation. While conventional echocardiography may not detect subtle changes, 2D-STE reveals improvements in LV function post-transplantation, emphasizing its role in assessing cirrhotic cardiomyopathy.

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Subclinical cardiac dysfunction detected by speckle-tracking echocardiography in patients with liver cirrhosis undergoing liver transplantation

Thu,

Hai,

et al. 2024

Egypt Liver Journal

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Echocardiographic evaluation in patient candidate for liver transplant: from pathophysiology to hemodynamic optimization

Iaconi,

Maritti,

Ettorre

et al. 2024

J Anesth Analg Crit Care

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Cardiovascular complications are common in patients with severe liver disease and are an important cause of peri-operative and post-transplant morbidity and mortality. Cirrhotic cardiomyopathy (CCM), often found in advanced liver disease, is characterized by diastolic dysfunction, systolic dysfunction, and electrophysiological abnormalities. While CCM may not cause symptoms at rest, it can become evident during stressful activities, such as surgery. Liver transplantation, while being the definitive treatment for end-stage liver disease (ESLD), carries significant cardiovascular risks. Preoperative cardiac evaluation is essential for assessing these risks and planning appropriate management. Cardiac imaging, particularly echocardiography, plays a crucial role in evaluating liver transplant candidates, helping to identify conditions such as CCM, pulmonary hypertension, hepatopulmonary syndrome, and others. Currently, liver transplant anesthetists must acquire echocardiographic knowledge and skills to evaluate the cardiocirculatory conditions of the transplanted patient, especially in the pre-operative phase, but also intra-operatively and post-operatively.

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Echocardiography in the Liver Transplant Patient

Cited by 2 publications

References 44 publications

Subclinical cardiac dysfunction detected by speckle-tracking echocardiography in patients with liver cirrhosis undergoing liver transplantation

Subclinical cardiac dysfunction detected by speckle-tracking echocardiography in patients with liver cirrhosis undergoing liver transplantation

Echocardiographic evaluation in patient candidate for liver transplant: from pathophysiology to hemodynamic optimization

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