Cirrhotic cardiomyopathy- Survival at 3 months after liver transplantation

Abstract

Background: Cirrhotic cardiomyopathy (CCM) occurs in 39.4%–48.3% of patients with chronic liver disease with or without decompensation. A significant number of patients are likely to be listed for liver transplantation (LT). The early outcome of LT in these patients is not known. Aims and Objectives: The aim is to study the prognostic implication of CCM on survival at 3 months post-LT. Materials and Methods: This prospective study was conducted from July 2016 to July 2017. Patients, who were diagnosed as cirrhosis of the liver based on clinical, biochemical, imaging, and endoscopic findings, were included in the study. After informed consent, details of demography, comorbidity, and cirrhosis-related complication were noted. Cardiac evaluation included electrocardiography, two-dimensional echocardiography, dobutamine stress test, and coronary angiography whenever indicated. CCM was diagnosed based on the standard criteria. Patients who underwent LT were followed up in the posttransplant period up to 3 months. Statistics: Mann–Whitney U-test, Chi-square test, and Kaplan–Meier survival plot were used for statistical analysis. P < 0.05 was considered statistically significant. Results: Five hundred and eighty-six adult patients with cirrhosis of the liver underwent cardiac evaluation. One hundred and ninety-eight (33.8%) patients were diagnosed with CCM. Forty-one patients underwent LT. Following LT, there was an improvement in diastolic dysfunction in a third of patients (12 patients; 29.3%) but with no survival benefit at 3 months (P = 0.23). Higher baseline model for end-stage liver disease and left ventricular diastolic dysfunction were more common among nonsurvivors. Conclusion: CCM does not influence the short-term survival in patients undergoing LT.

Keywords

• Cardiomyopathy
• cirrhosis
• liver
• outcome
• transplantation