Preoperative echocardiographic evaluation of cardiac systolic and diastolic function in liver transplant recipients with diabetes mellitus: a propensity-score matched analysis
Anesthesia and Pain Medicine
;
: 465-473, 2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-785359
ABSTRACT
BACKGROUND:
Diabetes mellitus (DM) increases risk of heart failure. It has been shown that diabetes leads to DM-cardiomyopathy, characterized by systolic and diastolic dysfunction. Pre-transplant diastolic dysfunction, has been associated with poor graft outcome and mortality. We assessed the hypothesis that end-stage liver disease (ESLD) patients with diabetes (DM-ESLD), have more advanced cardiac systolic and diastolic dysfunction, compared to ESLD patients without diabetes (Non DM-ESLD).METHODS:
We retrospectively evaluated preoperative echocardiography of 1,319 consecutive liver transplant recipients (1,007 Non DM-ESLD vs. 312 DM-ESLD [23.7%]) January 2012–May 2016. Systolic and diastolic indices, such as left ventricular ejection fraction, transmital E/A ratio, tissue doppler s′, e′ velocity, and E/e′ ratio (index of left ventricular end-diastolic pressure), were compared using 12 propensity-score matching.RESULTS:
DM-ESLD patients showed no differences in systolic indices of left ventricular ejection fraction and s′ velocity, whereas diastolic indices of E/A ratio ≤ 1 (49.0% vs. 40.2% P = 0.014), e′ velocity (median = 7.0 vs. 7.4 cm/s, P < 0.001) and E/e′ ratio (10.9 ± 3.2 vs. 10.1 ± 3.0, P < 0.001), showed worse diastolic function compare with Non DM-ESLD patients, respectively.CONCLUSIONS:
DM-ESLD patients suffer higher degree of diastolic dysfunction compared with Non DM-ESLD patients. Based on this, careful preoperative screening for diastolic dysfunction in DM-ESLD patients is encouraged, because poor transplant outcomes have been noted in patients with preoperative diastolic dysfunction.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Volume Sistólico
/
Ecocardiografia
/
Programas de Rastreamento
/
Estudos Retrospectivos
/
Mortalidade
/
Transplantes
/
Diabetes Mellitus
/
Insuficiência Cardíaca Diastólica
/
Insuficiência Cardíaca Sistólica
/
Pontuação de Propensão
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Estudo de rastreamento
Limite:
Humanos
Idioma:
Inglês
Revista:
Anesthesia and Pain Medicine
Ano de publicação:
2019
Tipo de documento:
Artigo
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