Congestive heart failure following liver transplantation: Echocardiographic predictors and response to therapy

H. V. Barron, E. Foster, J. R. Lake, J. P. Roberts, N. L. Ascher, C. L. Wolfe

Research output: Contribution to journalArticlepeer-review


Aim: To determine whether transthoracic echocardiography (TIB) can predict postoperative congestive heart failure (CHF) after liver transplantation in patients without known heart disease. Methods: Retrospective case-control study of seven patients who developed CHF after liver transplantation and 8 matched controls (C) (age 46±14 and 47±9 yrs, respectively) who did not develop CHF. Results: Patients with CHF were noted to have clinical and radiographic evidence of pulmonary edema (7/7 and pts) and significant reduction in LVEF (32±9%) from two to 126 days postoperatively. On preoperative TTE. CHF pts and the controls demonstrated similar LVEF (62±11 vs. 67±8) and end-diastolic volume index (EDVT) (89 ml/m2±33 vs. 68±37). However, CHF pts demontrated greater left left ventricular mass index (LVMI) (123 gm/m2±42 vs. 81±14 p ≤ 0.03), a greater incidence of LVH (83% vs 0%) and a trend toward a greater end-systolic volume index (ESVI) (35 ml/m2±15 vs. 22±10 p = 0.08). All CHF patients were treated with diuretics and vasodilator therapy (hydralazine and nitrates), resulting in resolution in signs and symptoms of CHF and improvement of LVEF (32±9% vs 59±10%). Conclusions: Patients who develop CHF after liver transplantation have similar preoperative systolic LV function but have a significantly increased LVMI. Treatment results in clinical improvement and restoration of systolic LV function. The value of TTE for predicting CHF following liver transplantation should be prospectively evaluated.

Original languageEnglish (US)
Pages (from-to)147A
JournalJournal of Investigative Medicine
Issue number1
StatePublished - 1996


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