Heart failure & cardiomyopathies
Left ventricular remodeling in end-stage liver disease and post-transplant mortality assessed using end-diastolic pressure-volume relation analysis: Observational retrospective study
Authors' conclusion
As ESLD advances, diastolic ventricular properties are characterized by increased EDVI20 and β on rightward-shifted EDPVR, indicating larger capacitance and higher stiffness. However, leftward-shifted EDPVR with left ventricle remodeling failure is associated with poor post-LT survival.
Study context
- Population
- Patients undergoing liver transplantation for end-stage liver disease; End-diastolic pressure-volume relationship (EDPVR) estimated from preoperative echocardiography1,090 with β > 6.16
- Participants
- 3,211 patients
- Exposure
- Leftward-shifted and intermediate EDPVR vs rightward-shifted EDPVR
- Outcome
- Cumulative all-cause mortality after liver transplantation
- Follow-up
- 11 years
Methodological detailsobservational
- Observational
Main finding
As reported in the abstract
All-cause mortality after liver transplantation (LT) (patients with β > 6.16)
Leftward-shifted
73.7%
Survival
Rightward-shifted
82.9%
Survival
Each group vs rightward-shiftedHazard ratio (95% CI)
Leftward-shifted
1.93(1.27–2.92)
Intermediate
1.55(1.12–2.26)
Observational data: associations, not effects.
Further findings
EDPVR variables by liver disease severity (MELD score)
- EDVI20 and β gradually increased as MELD score increased (larger capacitance, higher diastolic stiffness)
Variables associated with leftward-shifted EDPVR (SHAP model)
- DM, female sex, old age and hypertension
Original publication
Left ventricular remodeling in end-stage liver disease and post-transplant mortality assessed using end-diastolic pressure-volume relation analysis: Observational retrospective study. Am Heart J. Published 11 April 2023. doi:10.
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