Archives of the Turkish Society of Cardiology
Subclinical myocardial dysfunction in liver transplant candidates determined using speckle tracking imaging [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2019; 47(8): 638-645 | DOI: 10.5543/tkda.2019.94728

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

Saadet Demirtaş Inci1, Leyla Elif Sade2, Cihan Altın2, Bahar Pirat2, Hilal Erken Pamukcu1, Sabiye Yılmaz3, Haldun Müderrisoğlu2
1Department of Cardiology, Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
2Department of Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey
3Department of Cardiology, Ministry of Health Sakarya University Training and Research Hospital, Sakarya, Turkey


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.

Keywords: Echocardiography, end-stage liver disease; strain.

How to cite this article
Saadet Demirtaş Inci, Leyla Elif Sade, Cihan Altın, Bahar Pirat, Hilal Erken Pamukcu, Sabiye Yılmaz, Haldun Müderrisoğlu. Subclinical myocardial dysfunction in liver transplant candidates determined using speckle tracking imaging. Turk Kardiyol Dern Ars. 2019; 47(8): 638-645

Corresponding Author: Saadet Demirtaş Inci, Türkiye
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