Key result
Preoperative resting LVOT gradient >60 mmHg linked to ~4% greater 5-year mortality post-liver transplant.
Why the study?
HCM presents with left ventricular hypertrophy, often with LVOTO and sudden death risk, but outcomes in patients undergoing liver transplant were not well described.
Does preoperative maximal LV outflow tract gradient at rest > 60 mmHg predict 5-year mortality in patients with hypertrophic cardiomyopathy undergoing liver transplant?
Observational (n=29)
Does preoperative maximal LV outflow tract gradient at rest > 60 mmHg predict 5-year mortality in patients with hypertrophic cardiomyopathy undergoing liver transplant?
Effect estimate: HR 1.04 (95% CI 1.01-1.06)
In patients with hypertrophic cardiomyopathy undergoing liver transplant, a preoperative resting LV outflow tract gradient > 60 mmHg is associated with increased 5-year mortality.
BACKGROUND: Hypertrophic cardiomyopathy (HCM) presents with a hypertrophied left ventricle (LV). It is often associated with LV outflow tract obstruction (LVOTO) and a risk for sudden death. This study aimed to describe outcomes of patients with HCM who underwent liver transplant (LT). METHODS: A retrospective review was conducted for patients diagnosed with HCM undergoing LT. Patient characteristics, preoperative echocardiography results, HCM risk of sudden cardiac death prediction model score, and 5-year mortality were examined. A univariable Cox proportional hazards model was used to evaluate the association between risk factors and 5-year mortality. All tests were two-sided with the alpha level set at .05. RESULTS: Twenty-nine patients were included in the analysis. Six patients (21%) had a perioperative cardiopulmonary complication. The 5-year survival rate was 61% (95% CI, 45-82). The analyzed risk factors showed that 5-year post-LT survival was significantly predicted by maximal LV outflow tract gradient at rest > 60 mmHg (hazard ratio, 1.04 [95% CI, 1.01-1.06]). CONCLUSIONS: Preoperative LV outflow tract resting gradient > 60 mmHg was associated with 5-year post-LT mortality. The results suggest the severity of LVOTO identified by echocardiography is a prognostic tool for patients with HCM after LT.
No takes yet. Share an insight, caveat, or question.
Pai et al. (2021) conducted an observational in Hypertrophic cardiomyopathy undergoing liver transplant (n=29). Maximal LV outflow tract gradient at rest > 60 mmHg was evaluated on 5-year mortality (HR 1.04, 95% CI 1.01-1.06). Preoperative maximal left ventricular outflow tract resting gradient > 60 mmHg was significantly associated with 5-year mortality after liver transplant (HR 1.04; 95% CI 1.01-1.06).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: