Abstract 17185: Diastolic Dysfunction is a Risk Factor for Mortality in Patients Undergoing Liver Transplantation
Introduction. Cardiac dysfunction in cirrhotic patients is a compilation of manifestations that lead to a hyperdynamic state. The influence of the cardiovascular system and its derangements in these patients has been described but its influence on prognosis and outcome is not well defined.
Methods. A retrospective review of 348 patients that underwent liver transplantation at The Methodist Hospital from 2004-2010 was performed under an approved IRB protocol. Charts were obtained from the liver transplant database and information collected regarding cardiovascular profile previous to transplant. Logistic regression adjusted for confounders was performed and statistical significance is defined as p < 0.05.
Results. Patient demographics are described in table 1. 65% of the patients were male and 35% female. 65% were also Caucasian, 18% Hispanic and 10% African-American. There were several cardiovascular manifestations in this patient population such as prolonged QTc in 32%, rhythm abnormalities (predominantly heart block) in 9% of patients, pulmonary AV fistula in 18%, PFO in 9% and diastolic dysfunction was present in 22% of patients. When adjusting for possible confounders, Diastolic Dysfunction, independent of filling pressures, was the only predictor of mortality with a p <0.05 with an Odds Ratio and Confidence Interval of 2.3, 2.0-3.2 respectively.
Conclusions. In conclusion, Diastolic Dysfunction is a risk factor that needs to be considered when evaluating and managing cirrhotic patients that will undergo liver transplantation in order to reduce morbidity and mortality.
- © 2011 by American Heart Association, Inc.