Myocardial structural and functional changes in patients with liver cirrhosis awaiting liver transplantation: a comprehensive cardiovascular magnetic resonance and echocardiographic study.

ABSTRACT:

Background

Cardiac dysfunction is increasingly recognized in patients with liver cirrhosis. Nevertheless, the presence or absence of structural alterations such as diffuse myocardial fibrosis remains unclear. We aimed to investigate myocardial structural changes in cirrhosis, and explore left ventricular (LV) structural and functional changes induced by liver transplantation.

Methods

This study included 33 cirrhosis patients listed for transplantation and 20 healthy controls. Patients underwent speckle-tracking echocardiography and cardiovascular magnetic resonance (CMR) with extracellular volume fraction (ECV) quantification at baseline (n?=?33) and 1?year after transplantation (n?=?19).

Results

CMR-based LV ejection fraction (CMR_LV-EF) and echocardiographic LV global longitudinal strain (LV-GLS) demonstrated hyper-contractile LV in cirrhosis patients (CMR_LV-EF: 67.8?±?6.9% in cirrhosis vs 63.4?±?6.4% in healthy controls, P?=?0.027; echocardiographic GLS: -?24.2?±?2.7% in cirrhosis vs -?18.6?±?2.2% in healthy controls, P??0.1). Only one of the cirrhosis patients showed late gadolinium enhancement. However, cirrhosis patients showed a higher ECV (31.6?±?5.1% vs 25.4?±?1.9%, P?ConclusionsMyocardial extracellular volume expansion with augmented resting LV systolic function was characteristic of cirrhotic cardiomyopathy, which normalizes 1-year post-transplantation. Thus, myocardial extracellular expansion represents a structural component of myocardial changes in cirrhosis.

SUBMITTER: Kim HM 

PROVIDER: S-EPMC7178724 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature