Bibliographic Details
| Title: |
Clinical implications of inducible left ventricular outflow tract obstruction among patients undergoing liver transplant evaluation |
| Authors: |
Antoine Addoumieh, Mouin S. Abdallah, Jad A. Ballout, Lucy Thuita, Allan Klein, Wael A. Jaber, Reza Arsanjani, William Carey, David Majdalany |
| Source: |
American Heart Journal Plus, Vol 4, Iss , Pp 100026- (2021) |
| Publisher Information: |
Elsevier, 2021. |
| Publication Year: |
2021 |
| Collection: |
LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: |
End stage liver disease, Dobutamine stress echocardiography, Left ventricular outflow tract obstruction, Liver transplant evaluation, Cirrhosis of the liver, Echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: |
Introduction: Patients with end stage liver disease (ESLD) have a hyperdynamic state due to decreased systemic vascular resistance and increased cardiac output. Preoperative evaluation with dobutamine stress echocardiography (DSE) is used to risk-stratify patients prior to liver transplant. We sought to identify the impact of inducible left ventricular outflow tract obstruction (LVOTO) on DSE on post-operative liver transplant outcomes. Methods: Patients with ESLD who underwent liver transplant at Cleveland Clinic between January 2007 and August 2016 were identified. Pre-operative DSE data, and post-operative intensive care unit (ICU) data were extracted. Patients with inducible LVOTO were compared to those without LVOTO. Results: Of the 515 patients identified who underwent DSE prior to liver transplant, 165 (30%) were female, and 95 (18%) had LVOTO. There were no major differences in baseline characteristics between the two groups. In the LVOTO group, rest gradients were 10.8 ± 3 mm Hg while peak gradients were 90 ± 48.2 mm Hg. No significant differences in ICU length of stay or duration of mechanical ventilation between both groups were noted. There were 21 deaths at 30 days. There were 2 (2.1%) deaths in the LVOTO group, versus 19 (4.5%) deaths in the non LVOTO group (p = 0.28). Higher Model for End Stage Liver Disease (MELD) scores predicted longer duration of mechanical ventilation and ICU length of stay. Conclusion: Inducible LVOTO on DSE does not adversely affect the short-term outcomes post liver transplant. Presence of inducible LVOTO should not be the mere reason to deny liver transplant among patients with ESLD. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2666-6022 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2666602221000240; https://doaj.org/toc/2666-6022 |
| DOI: |
10.1016/j.ahjo.2021.100026 |
| Access URL: |
https://doaj.org/article/094e822026fd43b88c9b496a878dadae |
| Accession Number: |
edsdoj.094e822026fd43b88c9b496a878dadae |
| Database: |
Directory of Open Access Journals |
