22 March 2019 : Original article
Etiology of Liver Disease and Cardiovascular Abnormalities in Patients on a Liver Transplantation Waiting List
Michalina Galas1ABCDEF, Renata Glówczyńska1ABDEF*, Zbigniew Lewandowski2C, Andrzej Cacko3CD, Joanna Raszeja-Wyszomirska4BD, Piotr Milkiewicz4BD, Marek Krawczyk5DE, Krzysztof Zieniewicz5DE, Grzegorz Opolski1ADEDOI: 10.12659/AOT.913061
Ann Transplant 2019; 24:162-167
Abstract
BACKGROUND: The classical cardiovascular risk factors and changes in the circulatory system secondary to end-stage liver disease (ESLD) are associated with an increased risk of cardiac abnormalities (CAs) in patients waiting for liver transplantation (LTx). The aim of this study was to assess the relationship between the etiology of liver disease and the presence of CAs in patients qualified for LTx.
MATERIAL AND METHODS: The study enrolled patients qualified to LTx due to ESLD at the Clinical Hospital of the Medical University of Warsaw between 2013 and 2016. Out of 396 patients: 65, 157, 117, and 57 had ESLD due to the alcoholic liver disease (ALD), viral infections (VIR), autoimmune disorders (AUTO), and different etiologies (OTHER), respectively.
RESULTS: An increased frequency of hypertension and diabetes mellitus were observed in ALD and VIR groups, while for hyperlipidemia, the highest rates were observed in ALD and AUTO groups. Significant differences in CAs rates were observed for resting tachycardia, prolonged QT interval, bradycardia, and left ventricular diastolic dysfunction. After adjustment for age, MELD, and Child-Pugh scores, hyperlipidemia (26% vs. 7–15%, p<0.048) was most frequently observed in the AUTO group, while poor aerobic capacity (49% vs. 21–34%, p<0.009) dominated in the OTHER group.
CONCLUSIONS: The frequency of hyperlipidemia, and poor aerobic capacity were directly related to the etiology of liver disease, while the remaining associations resulted from effects of age, MELD, and Child-Pugh score.
Keywords: Cardiomyopathies, Cardiovascular Abnormalities, Liver Cirrhosis, Liver Transplantation, Autoimmune Diseases, Cardiovascular Diseases, End stage liver disease, Hepatitis, Viral, Human, Hyperlipidemias, Liver Diseases, Alcoholic, Organ Dysfunction Scores, perioperative period, Risk Factors, Waiting Lists
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