Hypertrophic Cardiomyopathy in Liver Transplantation Patients.

Autor: Pai SL; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: pai.sherlu@mayo.edu., Aniskevich S 3rd; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA., Logvinov II; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA., Matcha GV; Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA., Palmer WC; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA., Blackshear JL; Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida, USA.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2018 Jun; Vol. 50 (5), pp. 1466-1469. Date of Electronic Publication: 2018 Mar 10.
DOI: 10.1016/j.transproceed.2018.02.080
Abstrakt: Background: Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disorder that presents with a hypertrophied nondilated left ventricle. In the absence of other known causes of cardiomyopathy, it is often associated with left ventricular outflow tract obstruction during systole, systolic anterior motion of the mitral valve, mitral regurgitation, and increased risk of sudden cardiac death. When HCM coexists with end-stage liver disease, it can be further complicated by cirrhosis-associated cardiovascular abnormalities, including hyperdynamic circulation, systolic and diastolic dysfunction, and electrophysiologic abnormalities.
Methods: We retrospectively examined patient characteristics, comorbidities, preoperative echocardiogram results, sudden cardiac death risk prediction model score, and 1-year postoperative mortality of patients with HCM who underwent liver transplantation at our institution from January 1, 2000, through January 1, 2015.
Results: Of the 2,812 liver transplantations performed during the study period, we identified 15 patients with a preoperative diagnosis of HCM. When comparing the patients who did vs did not survive the first year after orthotopic liver transplantation, we identified significant differences in maximal left ventricular wall thickness (P = .004) and resting left ventricular outflow tract gradient (P = .004). Preoperative left atrium size (measured by echocardiography; P = .66) and the sudden cardiac death risk prediction model score (P = .32) were not significantly associated with 1-year survival.
Conclusions: Preoperative left ventricular outflow tract gradient exceeding 60 mm Hg was strongly associated with death during the first year after transplant. These results suggest that the severity of HCM influences patient outcomes.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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