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End stage liver cardiomyopathy

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https://www.readbyqxmd.com/read/29672903/cirrhotic-cardiomyopathy-after-transplantation-neither-the-transient-nor-innocent-bystander
#1
Manhal Izzy, Jae Oh, Kymberly D Watt
Cirrhotic cardiomyopathy in end stage liver disease is currently characterized by blunted contractile systolic response to stress with or without diastolic dysfunction in the absence of known heart disease. Since the establishment of the diagnostic criteria of cirrhotic cardiomyopathy in 2005, there have been multiple studies regarding its pathophysiology and pre-transplant clinical course. The data regarding the post-transplant course of this entity are sparse. This review addresses the course and prognosis of the elements of cirrhotic cardiomyopathy after liver transplantation...
April 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29660764/prognostic-utility-of-meld-xi-in-adult-congenital-heart-disease-patients-undergoing-cardiac-transplantation
#2
Evan D Adams, Nicholas J Jackson, Tim Young, Eugene C DePasquale, Leigh C Reardon
BACKGROUND: MELD-XI (Model for End-Stage Liver Disease eXcluding INR) at cardiac transplant has demonstrated prognostic survival utility, but has not been specifically validated in adult congenital heart disease (ACHD) in a registry study. METHODS: Adults undergoing first time orthotopic heart transplant from 2005-2015 in the UNOS (United Network for Organ Sharing) registry were examined in parallel: ACHD (n=543), ischemic dilated cardiomyopathy (IDCM, n=6,954) and valvular heart disease (VHD, n=355)...
April 16, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29455423/assessment-of-cerebral-microbleeds-by-susceptibility-weighted-imaging-at-3t-in-patients-with-end-stage-organ-failure
#3
Gianvincenzo Sparacia, Roberto Cannella, Vincenzina Lo Re, Angelo Gambino, Giuseppe Mamone, Roberto Miraglia
PURPOSE: Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors. MATERIALS AND METHODS: Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65...
February 17, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29323769/systolic-heart-failure-after-liver-transplantation-incidence-predictors-and-outcome
#4
Abraham Sonny, Srinivasa R Govindarajan, Wael A Jaber, Jacek B Cywinski
Although most patients presenting for liver transplantation have normal left ventricular function, some develop left ventricular failure after transplantation. The primary objective of our study was to determine the predictors of systolic heart failure (HF) occurring immediately after liver transplantation. Its etiology, prospects of recovery, and factors associated with nonrecovery were also studied. Liver transplantations performed at our institution from January 2006 to February 2015 were evaluated using prospectively collected institutional registries...
March 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/28686329/juvenile-onset-generalized-lipodystrophy-due-to-a-novel-heterozygous-missense-lmna-mutation-affecting-lamin-c
#5
Nivedita Patni, Chao Xing, Anil K Agarwal, Abhimanyu Garg
The LMNA gene contains 12 exons and encodes lamins A and C by alternative splicing within exon 10. While mutations in lamin A specific residues cause several diseases including lipodystrophy, progeria, muscular dystrophy, neuropathy, and cardiomyopathy, only three families with mutations in lamin C-specific residues are reported with cardiomyopathy, neuropathy, and muscular dystrophy so far. We now report two brothers with juvenile-onset generalized lipodystrophy due to a lamin C-specific mutation. The proband, a 23-year-old Caucasian male was reported to have generalized lipodystrophy at 3 weeks of age, developed diabetes, hypertriglyceridemia, hypertension and liver problems and died with complications of cirrhosis, and kidney failure...
September 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28655414/heart-and-heart-liver-transplantation-in-patients-with-hemochromatosis
#6
Monique R Robinson, Sadeer G Al-Kindi, Guilherme H Oliveira
BACKGROUND: Hemochromatosis predisposes to dilated or restrictive cardiomyopathy which can progress to end-stage heart failure, requiring the use of advanced heart therapies including heart (HT) and heart liver (HLT) transplantation. Little is known about the characteristics and outcomes of these patients. METHODS AND RESULTS: We queried the United Network for Organ Sharing (UNOS) registry for all patients listed for HT or HLT for a diagnosis of 'hemochromatosis' between 1987 and 2014...
October 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28414689/radiology-case-of-the-month-mental-disturbance-for-4-days
#7
Matthew Brunner, Enrique Palacios, Harold Neitzschman, Jeremy Mguyen
A 56 year old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulders were noted. The patient's history was significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary hypertension and alcoholic cardiomyopathy. He had multi-decade history of heavy alcohol abuse, but quit drinking two years previously.
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28407402/cirrhotic-cardiomyopathy-implications-for-liver-transplantation
#8
REVIEW
Hongqun Liu, Saumya Jayakumar, Mouhieddin Traboulsi, Samuel S Lee
The majority of patients on a waiting list for liver transplantation have end-stage liver disease. Because of the marked peripheral vasodilatation of end-stage cirrhosis that masks a latent myocardial dysfunction, cardiac abnormalities in the resting state are usually subclinical and escape the attention of physicians. However, when challenged, the systolic and diastolic contractile responses are attenuated. In addition to these contractile abnormalities, morphological changes, such as enlargement or hypertrophy of cardiac chambers, and electrophysiological repolarization changes, including a prolonged QT interval, can be observed...
June 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28242556/intracavitary-ethanol-ablation-for-the-management-of-uterine-hemorrhage-refractory-to-uterine-artery-embolization
#9
Taylor M Morris, David H Ballard, Horacio B D'Agostino
A 57-year-old postmenopausal woman with end-stage liver disease secondary to alcoholic cirrhosis, esophageal varices, severe alcoholic cardiomyopathy, and metrorrhagia causing persistent anemia despite multiple transfusions presented with heavy vaginal bleeding. The patient underwent two uterine artery embolizations with proximal coils instead of directed particles due to difficult anatomy but the bleeding continued despite these interventions. Since she was a poor surgical candidate for hysterectomy, the decision was made to attempt achievement of hemostasis via ethanol injection into the uterine cavity...
May 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28164120/coronary-computed-tomography-angiography-in-combination-with-coronary-artery-calcium-scoring-for-the-preoperative-cardiac-evaluation-of-liver-transplant-recipients
#10
REVIEW
Jae Moon Choi, Yu-Gyeong Kong, Joon-Won Kang, Young-Kug Kim
Liver transplantation is the best treatment option for early-stage hepatocellular carcinoma, liver cirrhosis, fulminant liver failure, and end-stage liver diseases. Even though advances in surgical techniques and perioperative care have improved postoperative outcomes, perioperative cardiovascular complications are a leading cause of postoperative morbidity and mortality following liver transplantation. Ischemic coronary artery disease (CAD) and cardiomyopathy are the most common cardiovascular diseases and could be negative predictors of postoperative outcomes in liver transplant recipients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/27805244/takotsubo-cardiomyopathy-post-liver-transplantation
#11
Ahmed Vachiat, Keir McCutcheon, Adam Mahomed, Gunter Schleicher, Liezl Brand, Jean Botha, Martin Sussman, Pravin Manga
A patient with end-stage liver disease developed stress-induced Takotsubo cardiomyopathy post liver transplantation, with haemodynamic instability requiring a left ventricular assist device. We discuss the diagnosis and management of this condition.
October 23, 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27686680/effect-of-ventriculo-arterial-coupling-on-transplant-outcomes-in-cirrhotics-analysis-of-pressure-volume-curve-relations
#12
Won-Jung Shin, Jun-Gol Song, In-Gu Jun, Young-Jin Moon, Hye-Mee Kwon, Kyeowoon Jung, Seon-Ok Kim, Gyu-Sam Hwang
BACKGROUND & AIMS: Ventriculo-arterial coupling (VAC) reflects the interaction between ventricular performance and effective arterial load. Current criteria for cirrhotic cardiomyopathy focus only on cardiac function without addressing the effect of hyperdynamic, low-resistance circulation. We investigated alterations in VAC in cirrhotic patients and their associations with post-liver transplant all-cause mortality. METHODS: In this single institution cohort study, cirrhotic patients who underwent liver transplantation (LT) (n=914) were retrospectively compared with healthy matched controls using noninvasively measured end-systolic ventricular elastance (Ees), arterial elastance (Ea), and VAC (Ea/Ees)...
February 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/26915857/diastolic-dysfunction-in-liver-cirrhosis-prognostic-predictor-in-liver-transplantation
#13
F Carvalheiro, C Rodrigues, T Adrego, J Viana, H Vieira, C Seco, L Pereira, F Pinto, A Eufrásio, C Bento, E Furtado
BACKGROUND: Patients with liver cirrhosis may develop cirrhotic cardiomyopathy (CC), characterized by blunted contractile responsiveness to stress, diastolic dysfunction (DD), and electrophysiological abnormalities. It may adversely affect the long-term prognosis of these patients. METHODS: We conducted a retrospective analysis of patients undergoing liver transplantation (LT) for cirrhosis from January 2012 to June 2015. We analyzed demographic characteristics, the etiology of cirrhosis, Child-Pugh and Model for End-Stage Liver Disease (MELD) scores, the corrected QT (QTc) interval in the preoperative period, diastolic and systolic dysfunction, mortality and survival, and duration of mechanical ventilation and vasopressor support in the post-LT period...
January 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/26839643/cirrhotic-cardiomyopathy-isn-t-stress-evaluation-always-required-for-the-diagnosis
#14
Mara Barbosa, Joana Guardado, Carla Marinho, Bruno Rosa, Isabel Quelhas, António Lourenço, José Cotter
AIM: To describe the proportion of patients with cirrhotic cardiomyopathy (CCM) evaluated by stress echocardiography and investigating its association with the severity of liver disease. METHODS: A cross-sectional study was conducted. Cirrhotic patients without risk factors for cardiovascular disease were included. Data regarding etiology and severity of liver disease (Child-Pugh score and model for end-stage liver disease), presence of ascites and gastroesophageal varices, pro-brain natriuretic peptide (pro-BNP) and corrected QT (QTc) interval were collected...
January 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/26680081/combined-heart-and-liver-transplantation-the-cedars-sinai-experience
#15
H J Reich, M Awad, A Ruzza, M A De Robertis, D Ramzy, N Nissen, S Colquhoun, F Esmailian, A Trento, J Kobashigawa, L S Czer
PURPOSE: Combined heart-liver transplantation is an increasingly accepted treatment for select patients with heart and liver disease. Despite growing optimism, heart-liver transplantation remains an infrequent operation. We report our institutional experience with heart-liver transplantation. METHODS: All combined heart-liver transplantations at Cedars-Sinai Medical Center from 1998-2014 were analyzed. Primary outcomes were patient and graft survival and secondary outcomes included rejection, infection, reoperation, length of stay, and readmission...
November 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/26202764/diastolic-cardiac-dysfunction-is-a-predictor-of-dismal-prognosis-in-patients-with-liver-cirrhosis
#16
Dimitrios S Karagiannakis, Jiannis Vlachogiannakos, Georgios Anastasiadis, Irini Vafiadis-Zouboulis, Spiros D Ladas
BACKGROUND AND PURPOSE: Left ventricular diastolic dysfunction (LVDD) constitutes the prominent characteristic of cirrhotic cardiomyopathy, but its relevance on the clinical course of cirrhotic patients has not been clearly defined. The aim of the study was to evaluate the relationship of LVDD with the severity and etiology of liver disease and to investigate whether it affects the outcome of cirrhotic patients. METHODS: Cardiac function of 45 cirrhotics was studied by a tissue Doppler imaging echocardiography...
October 2014: Hepatology International
https://www.readbyqxmd.com/read/26118926/anesthesia-for-liver-transplantation
#17
REVIEW
Aparna Dalal
Patients with end stage liver disease (ESLD) have complex problems such as cirrhotic cardiomyopathy, coronary artery disease, hepatopulmonary syndrome (HPS), portopulmonary hypertension (POPH), hepatic encephalopathy, intracranial hypertension, (ICP), left ventricular outflow tract obstruction (LVOTO), high Model of end liver disease (MELD) scores, hyponatremia, and coagulopathies. The anesthesia management for liver transplantation can be very complex, dynamic and challenging. Anesthesia agents affect hepatic blood flow and anesthetic drug distribution, metabolism and elimination maybe altered in end stage liver disease...
January 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/25888085/adult-heart-transplantation-with-distant-procurement-and-ex-vivo-preservation-of-donor-hearts-after-circulatory-death-a-case-series
#18
Kumud K Dhital, Arjun Iyer, Mark Connellan, Hong C Chew, Ling Gao, Aoife Doyle, Mark Hicks, Gayathri Kumarasinghe, Claude Soto, Andrew Dinale, Bruce Cartwright, Priya Nair, Emily Granger, Paul Jansz, Andrew Jabbour, Eugene Kotlyar, Anne Keogh, Christopher Hayward, Robert Graham, Phillip Spratt, Peter Macdonald
BACKGROUND: Orthotopic heart transplantation is the gold-standard long-term treatment for medically refractive end-stage heart failure. However, suitable cardiac donors are scarce. Although donation after circulatory death has been used for kidney, liver, and lung transplantation, it is not used for heart transplantation. We report a case series of heart transplantations from donors after circulatory death. METHODS: The recipients were patients at St Vincent's Hospital, Sydney, Australia...
June 27, 2015: Lancet
https://www.readbyqxmd.com/read/25881709/complications-of-cirrhosis-a-50-years-flashback
#19
REVIEW
Søren Møller, Flemming Bendtsen
In patients with cirrhosis and portal hypertension, it is largely the frequency and severity of complications relating to the diseased liver, degree of portal hypertension and hemodynamic derangement that determine the prognosis. It can be considered as a multiple organ failure that apart from the liver involves the heart, lungs, kidneys, the immune systems and other organ systems. Progressive fibrosis of the liver and subsequent metabolic impairment leads to a systemic and splanchnic arteriolar vasodilatation...
June 2015: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/25856382/high-rate-of-cardiac-abnormalities-in-a-postmortem-analysis-of-patients-suffering-from-liver-cirrhosis
#20
Malte H Wehmeyer, Anika J Heuer, Daniel Benten, Klaus Püschel, Karsten Sydow, Ansgar W Lohse, Stefan Lüth
BACKGROUND: Cirrhotic cardiomyopathy is a recently defined cardiac disorder in patients with end-stage liver disease. The frequency and exact manifestations of cardiac changes in liver cirrhosis is unknown. GOALS: We aim to describe cardiac changes in a large autopsy study of patients with liver cirrhosis. STUDY: Postmortem data from 895 individuals with liver cirrhosis of different origin autopsied from 1995 to 2010 were analyzed. A total of 236 patients were excluded, mostly due to an advanced age above 70 years...
November 2015: Journal of Clinical Gastroenterology
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