title: Preoperative left ventricular hypertrophy is associated with reduced patient survival after liver transplantation.
abstract: Left ventricular hypertrophy (LVH) has been described in the context of cirrhotic cardiomyopathy. The influence of LVH on survival of liver transplant (LT) recipients has not been clarified. Therefore, we evaluated the effect of LVH on survival in LT recipients. In total, data from 352 LT patients were analyzed. LVH was diagnosed by echocardiographic measurement of left ventricular wall thickness before LT. Patients were followed up for a mean of 4.2 yr. LVH was diagnosed in 135 (38.4%) patients. Patients with LVH had significantly more frequently male gender (p = 0.046), diastolic dysfunction (p < 0.001), and hepatocellular carcinoma (HCC; p = 0.004). Furthermore, LVH patients were older (p < 0.001) and had a higher body mass index (BMI; p = 0.001). There was no difference in frequency of arterial hypertension, pre-transplant diabetes mellitus, or etiology of liver cirrhosis. Patients without LVH had a better survival (log rank: p = 0.05) compared with LVH patients. In a multivariate Cox regression LVH (p = 0.031), end-stage renal disease (ESRD; p = 0.003) and lack of arterial hypertension (p = 0.004) but not MELD score (p = 0.885) were associated with poorer survival.
  
  
  CONCLUSIONS
  LVH is frequently diagnosed in patients on the waiting list and influences survival after LT.
authors.affiliation: I. Medizinische Klinik der Universitätsmedizin Mainz, Mainz, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Darstein
authors.forename: C
authors.initials: C
authors.lastname: König
authors.forename: M
authors.initials: M
authors.lastname: Hoppe-Lotichius
authors.forename: D
authors.initials: D
authors.lastname: Grimm
authors.forename: J
authors.initials: J
authors.lastname: Knapstein
authors.forename: J
authors.initials: J
authors.lastname: Mittler
authors.forename: A
authors.initials: A
authors.lastname: Zimmermann
authors.forename: G
authors.initials: G
authors.lastname: Otto
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: P R
authors.initials: PR
authors.lastname: Galle
authors.forename: T
authors.initials: T
authors.lastname: Zimmermann
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000401:mortality*; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D057234:Preoperative Period; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
keywords: cirrhosis; cirrhotic cardiomyopathy; left ventricular hypertrophy; liver transplantation; survival