Journal
JOURNAL OF CLINICAL MEDICINE
Volume 9, Issue 8, Pages -Publisher
MDPI
DOI: 10.3390/jcm9082616
Keywords
strain analysis; echocardiography; cirrhotic cardiomyopathy; cardiac systolic function; dobutamine stress test; outcome
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Funding
- Medizinische Fakultat, RWTH Aachen University, program ROTATION
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Speckle tracking echocardiography enables the detection of subclinical left ventricular dysfunction at rest in many heart diseases and potentially in severe liver diseases. It could also possibly serve as a predictor for survival. In this study, 117 patients evaluated for liver transplantation in a single center between May 2010 and April 2016 with normal left ventricular ejection fraction were included according to clinical characteristics of their liver disease: (1) compensated (n= 29), (2) clinically significant portal hypertension (n= 49), and (3) decompensated (n= 39). Standard echocardiography and speckle tracking echocardiography were performed at rest and during dobutamine stress. Follow-up amounted to three years to evaluate survival and major cardiac events. Altogether 67% (78/117) of the patients were transplanted and 32% (31/96 patients) died during the three-year follow-up period. Global longitudinal strain (GLS) at rest was significantly increased (became more negative) with the severity of liver disease (p< 0.001), but reached comparable values in all groups during peak stress. Low (less negative) GLS values at rest (male: >-17/female: >-18%) could predict patient survival in a multivariate Cox regression analysis (p= 0.002). GLS proved valuable in identifying transplant candidates with latent systolic dysfunction.
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