Key result
Biliary atresia was associated with subclinical left ventricular systolic dysfunction, evidenced by significantly reduced global longitudinal strain before (-20.86% vs -22.79%) and after (-21.47% vs -22.89%) liver transplantation compared to healthy controls.
Why the study?
To evaluate ventricular systolic function in patients with biliary atresia before and after liver transplantation using two-dimensional speckle tracking.
Does liver transplantation improve subclinical left ventricular systolic dysfunction in pediatric patients with biliary atresia?
Cross-Sectional (n=120)
No
Does liver transplantation improve subclinical left ventricular systolic dysfunction in pediatric patients with biliary atresia?
Absolute Event Rate: -20.86% vs -22.79%
p-value: p=0.001
Two-dimensional speckle tracking reveals subclinical left ventricular systolic dysfunction in pediatric patients with biliary atresia both before and after liver transplantation.
Subclinical LV dysfunction in biliary atresia may warrant cardiac surveillance; leaves open whether GLS monitoring alters outcomes in prospective studies.
To evaluate the ventricular function of patients with biliary atresia (BA) before and after liver transplantation using two-dimensional speckle tracking. Observational, analytical study with healthy control group, volunteers. We recruited patients from 0 to 18 years old who were candidates for liver transplantation and patients after six months of liver transplantation performed for BA from January 1997 to August 2015 at Children's Institute of São Paulo University Medical School. The patients were submitted to a complete conventional echocardiographic study. After that, the images were captured for global longitudinal strain (GLS). A blood sample was collected for brain natriuretic peptide (BNP) level. Ejection fraction obtained by Simpson's method was significantly higher in the hepatic pre-transplantation group (p < 0.001), as well as left atrial size (p < 0.001) and left ventricle size (p = 0.039). The left ventricular mass index was significantly higher in pre-transplantation group (p < 0.001). The left atrium volume (p = 0.008) and the left ventricular mass index (p t = 0.035) were higher in the post-transplant group. It was observed that the lower the BNP, the lower/more negative the GLS in the post-transplant group (p = 0.038 and r = 0.427). Significant reduction in the overall longitudinal strain of the left ventricle was detected before (p = 0.01) and after liver transplantation (p = 0.019). A subclinical left ventricular systolic dysfunction was evidenced by two-dimensional speckle tracking technique before and after liver transplantation, even when compared to normal values of the last pediatric meta-analysis.
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Brito et al. (2021) conducted a cross-sectional in Biliary atresia (n=120). Biliary atresia (pre- and post-liver transplantation) vs. Healthy volunteers was evaluated on Left ventricular global longitudinal strain (LV GLS) in pre-transplant patients (p=0.001). Biliary atresia was associated with subclinical left ventricular systolic dysfunction, evidenced by significantly reduced global longitudinal strain before (-20.86% vs -22.79%) and after (-21.47% vs -22.89%) liver transplantation compared to healthy controls.
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