Diastolic dysfunction: Prevalence and outcome in liver transplantation candidates

Abstract

Introduction and Objectives

Cirrhotic cardiomyopathy (CCM) is a cardiac complication of cirrhosis primarily presenting as diastolic dysfunction (DD). The original diagnostic criteria from 2005 were updated in 2019. This retrospective study aimed to determine the prevalence and clinical impact of DD in liver transplantation (LT) candidates.

Materials and Methods

Data from 233 adult cirrhotic LT candidates were analyzed, and echocardiographic data were used to define DD in all patients using the original criteria and the revised criteria.

Results

The prevalence of DD was 72,1 % using the original criteria for DD and 6,4 % using the revised criteria. Patients with DD according to the revised criteria were older than those without DD. Other clinical characteristics were similar between groups. Waitlist mortality was 13,3 % in patients with DD versus 9,2 % in patients without DD (NS), according to the revised criteria. A similar percentage of patients with DD (80 %) underwent LT compared to patients without DD (89 %). Post-LT survival rates were comparable between patients with DD (87,3 % by original criteria, 91,7 % by revised criteria) and patients without DD (81,3 % by original and 85,6 % by revised criteria). Notably, lower e’ lateral values pre-LT were associated with post-LT mortality. Major adverse cardiovascular events post-transplantation occurred in 16,7 % of patients with pre-LT DD and in 13,9 % of patients without pre-LT DD (NS).

Conclusions

According to the revised criteria, 6,4 % of LT candidates in this cohort had DD. The presence of DD did not significantly impact overall post-transplant mortality.