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Postoperative alterations in ventriculoarterial coupling are an indicator of cardiovascular outcomes in liver transplant recipients.
- Source :
- Korean Journal of Anesthesiology; Apr2024, Vol. 77 Issue 2, p217-225, 9p
- Publication Year :
- 2024
-
Abstract
- Background: Liver transplantation (LT) increases the heart and vessel workload in patients with cirrhotic cardiomyopathy. While the interaction of the left ventricle (LV) with the arterial system (ventriculoarterial coupling, VAC) is a key determinant of cardiovascular performance, little is known about changes in VAC after LT. Therefore, we evaluated the relationship between VAC after LT and cardiovascular outcomes. Methods: 344 consecutive patients underwent echocardiographic assessments before and within 30 days after LT. Non-invasive arterial elastance (Ea), LV end-systolic elastance (Ees), and LV end-diastolic elastance (Eed) were calculated. The postoperative outcomes included the development of major adverse cardiovascular events (MACE) and the length of stay in the intensive care unit and hospital. Results: A total of 240 patients were included in the analyses. After LT, Ea increased by 16% (P < 0.001), and Ees and contractility index of systolic velocity (S') increased by 18% (P < 0.001) and 7% (P < 0.001), respectively. The Eed increased by 6% (P < 0.001). The VAC remained unchanged (0.56 to 0.56, P = 0.912). Of these patients, 29 had MACE, and those with MACE had significantly higher postoperative VAC. Additionally, a higher postoperative VAC was an independent risk factor for a longer postoperative hospital stay (P = 0.038). Conclusions: These data suggest that ventriculoarterial decoupling is associated with poor postoperative outcomes after LT. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 20056419
- Volume :
- 77
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Korean Journal of Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 176711001
- Full Text :
- https://doi.org/10.4097/kja.23266