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

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 st...

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Main Authors: Shenghua Bi, Yueping Jiang, Wenjun Zhao, Xiaoyan Niu, Xuechun Liu, Xue Jing
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-01-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2022.1072908/full
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author Shenghua Bi
Yueping Jiang
Wenjun Zhao
Xiaoyan Niu
Xuechun Liu
Xue Jing
author_facet Shenghua Bi
Yueping Jiang
Wenjun Zhao
Xiaoyan Niu
Xuechun Liu
Xue Jing
author_sort Shenghua Bi
collection DOAJ
description 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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spelling doaj.art-cf8892994b624978bf98a1c38ad6c04b2023-01-06T15:28:22ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10729081072908The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysisShenghua Bi0Yueping Jiang1Wenjun Zhao2Xiaoyan Niu3Xuechun Liu4Xue Jing5Gastroenterology Department, The Affiliated Hospital of Qingdao University, Qingdao, ChinaGastroenterology Department, The Affiliated Hospital of Qingdao University, Qingdao, ChinaGastroenterology Department, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, ChinaGastroenterology Department, The Affiliated Hospital of Qingdao University, Qingdao, ChinaGastroenterology Department, The Affiliated Hospital of Qingdao University, Qingdao, ChinaBackgroundDiastolic 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.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1072908/fulldecompensated cirrhosiscirrhotic cardiomyopathyliver transplantationadverse eventsmortality
spellingShingle Shenghua Bi
Yueping Jiang
Wenjun Zhao
Xiaoyan Niu
Xuechun Liu
Xue Jing
The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
Frontiers in Surgery
decompensated cirrhosis
cirrhotic cardiomyopathy
liver transplantation
adverse events
mortality
title The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
title_full The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
title_fullStr The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
title_full_unstemmed The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
title_short The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
title_sort predictive value of revised diastolic dysfunction in outcomes of liver transplantation a propensity score matching analysis
topic decompensated cirrhosis
cirrhotic cardiomyopathy
liver transplantation
adverse events
mortality
url https://www.frontiersin.org/articles/10.3389/fsurg.2022.1072908/full
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