Cirrhotic cardiomyopathy: Appraisal of the original and revised criteria in predicting posttransplant cardiac outcomes

Ashley Spann; Christopher Coe; Teminioluwa Ajayi; Garren Montgomery; Mohammed Shwetar; Adesola Oje; Jeffrey Annis; James C. Slaughter; Sophoclis Alexopoulos; Evan Brittain; Manhal Izzy

doi:10.1002/lt.26460

journal article Jun 16, 2022

Cirrhotic cardiomyopathy: Appraisal of the original and revised criteria in predicting posttransplant cardiac outcomes

Ashley Spann

Christopher Coe Teminioluwa Ajayi Garren Montgomery Mohammed Shwetar Adesola Oje Jeffrey Annis

James C. Slaughter Sophoclis Alexopoulos Evan Brittain Manhal Izzy

Liver Transplantation Vol. 28 No. 8 pp. 1321-1331 · Ovid Technologies (Wolters Kluwer Health)

View at Publisher Save 10.1002/lt.26460

Abstract

Abstract
Cardiovascular disease (CVD) significantly contributes to morbidity and mortality after liver transplantation (LT). Cirrhotic cardiomyopathy (CCM) is a risk factor for CVD after transplant. CCM criteria were originally introduced in 2005 with a revision proposed in 2020 reflecting echocardiographic technology advancements. This study assesses the two criteria sets in predicting major adverse cardiac events (MACE) after transplant. This single‐center retrospective study reviewed adult LT recipients between January 1, 2009, and December 31, 2018. Patients with insufficient pre‐LT echocardiographic data, prior ischemic heart disease, portopulmonary hypertension, or longitudinal care elsewhere were excluded. The primary composite outcome was MACE (arrhythmia, heart failure, cardiac arrest, and/or cardiac death) after transplant. Of 1165 patients, 210 met the eligibility criteria. CCM was present in 162 patients (77%) per the original criteria and 64 patients (30%) per the revised criteria. There were 44 MACE and 31 deaths in the study period. Of the deaths, 38.7% occurred secondary to CVD. CCM defined by the original criteria was not associated with MACE after LT (p = 0.21), but the revised definition was significantly associated with MACE (hazard ratio [HR], 1.93; 95% confidence interval, 1.05–3.56; p = 0.04) on multivariable analysis. Echocardiographic variable analysis demonstrated low septal e’ as the most predictive variable for MACE after LT (HR, 3.45; p < 0.001). CCM, only when defined by the revised criteria, was associated with increased risk for MACE after LT, validating the recently revised CCM definition. Abnormal septal e’, reflecting impaired relaxation, appears to be the most predictive echocardiographic criterion for MACE after LT.

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Metrics

47

Citations

34

References

Details

Published: Jun 16, 2022
Vol/Issue: 28(8)
Pages: 1321-1331
License: View

Authors

A

Ashley Spann

12328,Division of Gastroenterology, Hepatology, and Nutrition,Vanderbilt University Medical Center,Nashville,Tennessee,USA

C

Christopher Coe

Division of Gastroenterology and Hepatology,University of California Los Angeles,Los Angeles,California,USA

T

Teminioluwa Ajayi

3989,Division of Gastroenterology and Hepatology,Baylor College of Medicine,Houston,Texas,USA

G

Garren Montgomery

12328,Department of Medicine,Vanderbilt University Medical Center,Nashville,Tennessee,USA

M

Mohammed Shwetar

Department of Medicine,University of Virginia,Charlottesville,Virginia,USA

A

Adesola Oje

12328,Department of Medicine,Vanderbilt University Medical Center,Nashville,Tennessee,USA

J

Jeffrey Annis

12328,Division of Cardiovascular Medicine,Vanderbilt University Medical Center,Nashville,Tennessee,USA

J

James C. Slaughter

12328,Department of Biostatistics,Vanderbilt University Medical Center,Nashville,Tennessee,USA

S

Sophoclis Alexopoulos

12328,Division of Hepatobiliary Surgery and Liver Transplantation,Vanderbilt University Medical Center,Nashville,Tennessee,USA

E

Evan Brittain

12328,Division of Cardiovascular Medicine,Vanderbilt University Medical Center,Nashville,Tennessee,USA

M

Manhal Izzy

12328,Division of Gastroenterology, Hepatology, and Nutrition,Vanderbilt University Medical Center,Nashville,Tennessee,USA

Cite This Article

Ashley Spann, Christopher Coe, Teminioluwa Ajayi, et al. (2022). Cirrhotic cardiomyopathy: Appraisal of the original and revised criteria in predicting posttransplant cardiac outcomes. Liver Transplantation, 28(8), 1321-1331. https://doi.org/10.1002/lt.26460

Cirrhotic cardiomyopathy: Appraisal of the original and revised criteria in predicting posttransplant cardiac outcomes

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