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Diastolic dysfunction and pulmonary pressure can be correlation with severity of liver cirrhosis in liver transplantation patients
대구 가톨릭 대학병원 순환기 내과
홍승표, 김병규, 손자영, 이영수, 이진배, 류재근, 최지용, 김기식, 장성국
Background: Many cirrhotic patients undergoing liver transplantation(LT) showed signs of cardiac dysfunction and overt heart failure were an important cause of death after LT. The aim of the study was to assess the correlation of the severity of liver cirrhosis(LC) and heart function in LT patients. Methods: We conducted a retrospective analysis of collected data on 72 consecutive patients (mean age 43years, male: 53.1%) who had been performed liver transplantation between April 2006 and April 2009 at our center. We excluded the patients with acute fulminent hepatitis, hepatocelluar carcinoma without LC. The severity of LC using Child-Turcotte-Pugh(CTP) score and Model for End-stage Liver Disease(MELD) score were evaluated. Results: Child C group demonstrated significantly higher left ventricular mass index (LVMI, P =0.001) and left atrial volume index (LAVI, P= 0.012) than Child B group. Moreover, Child C group showed significantly higher E/E' (P=0.020) and pulmonary artery systolic pressure (PASP, P= 0.017) than Child B group. On the other hand, LV Ejection fraction(EF) was similar in both groups (p = 0.079). But, MELD score was not correlation of LVMI (R=0.155, P=0.188), LAVI (R=0.076, P=0.545), E/E’ (R=0.020, P=0.617), PASP (R=0.017, P=0.824) and LVEF (R=0.002, P=0.731). Conclusions: The severity of LC according to CTP score in LT patients was correlated with diastolic dysfunction.

Variables

Child B group

(N=38, Mean score: 7.8)

Child B group

(N=34, Mean score: 10.1)

P value

Age (years)

42.54 ± 13.12

44.84 ± 16.32

0.998

Sex (male, %)

20 (52.6%)

17 (50.0%)

0.505

BMI (kg/m2)

22.76 ± 11

22.11 ± 3.81

0.084

SBP (mmHg)

121.98 ± 11.27

120.42 ± 13.31

0.223

DBP (mmHg)

70.88 ± 12.29

73.83 ± 12.05

0.602

PP (mmHg)

50.30 ± 8.91

64.81 ± 10.64

0.187

HR (frequency/min)

67.19 ± 9.91

64.81 ± 10.64

0.540

LVEF (%)

66.64 ± 5.37

67.38 ± 4.52

0.542

LAVI (ml/m2)

33.59 ± 9.80

40.41 ± 10.25

0.001

LVMI (g/m2)

114.94 ± 24.61

138.21 ± 31.77

0.001

E/E ratio

8.84 ± 2.04

10.25 ± 2.89

0.020

PASP (mmHg)

30.31 ± 6.32

34.53 ± 7.20

0.017



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