Subclinical myocardial dysfunction in liver transplant candidates determined using speckle tracking imaging

• Main Authors: Saadet Demirtaş Inci, Leyla Elif Sade, Cihan Altın, Bahar Pirat, Hilal Erken Pamukcu, Sabiye Yılmaz, Haldun Müderrisoğlu
• Format: Article
• Language: English
• Published: KARE Publishing 2019-12-01
• Series: Türk Kardiyoloji Derneği Arşivi
• Subjects: echocardiography; end-stage liver disease; strain.
• Online Access: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-94728

Objective: There are various cardiovascular abnormalities in end-stage liver disease (ESLD). In these patients, left ventricular (LV) systolic function is normal at rest but deteriorates during stress. This deterioration may be due to subclinical myocardial dysfunction. This study evaluated global LV and right ventricular (RV) functions using 2-dimensional (2D) speckle tracking in patients with ESLD. Methods: Forty liver transplant candidates with ESLD and 26 healthy individuals were included in the study. All of the patients underwent conventional echocardiographic measurement. Longitudinal, circumferential, and radial strain measurements, as well as apical and parasternal short-axis image recordings were obtained. All 2D strain measurements were measured with offline analysis using velocity vector imaging (VVI) software. Results: In the apical 4- and 2-chamber measurements, the LV mean longitudinal strain was significantly lower in the patient group compared with that of the control group (-16.0+-3.2% versus -17.6+-2.2%, -16.7+-3.3% versus -18.7 +-2.1 +- 2.1 %; p=0.002, respectively). The LV mean circumfe-rential strain did not differ between groups. The LV mean radial strain and RV longitudinal strain were significantly lower in the patient group (45.4+-10.7 vs. 52.7+-10.8%; p=0.01 and -19.2+-3.5% versus -21.5+-3.6%; p=0.03, respectively). Conclusion: Subclinical impairment of global LV and RV systolic functions was determined in liver transplantation candidates using VVI. This deterioration was detected in longitudinal and radial deformation rather than circumferential deformation mechanics, which is consistent with early-stage LV myocardial dysfunction.