Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose: Stress cardiomyopathy is a pathological condition in which excess catecholamines leading to cardiac dysfunction. This phenomenon is associated with troponin elevation, EKG changes, and cardiac dysfunction in a distribution of multiple vascular territories with subsequent recovery. Though best described in the setting of sub-arachnoid hemorrhage, it has been increasingly reported in other situations associated with excess physiological stress. Here we report on our experience of post liver transplant stress cardiomyopathy.
Methods: We retrospectively analyzed all liver transplant recipients from 1/2003 and 3/2015. Patients undergoing cardiac catheterizations or echocardiography post-operative were queried from the Cleveland Clinic transplant database. 8 patients were identified as likely cases of stress cardiomyopathy based on 4 criteria: 1) EKG changes, 2) troponin T elevations, 3) echocardiography suggesting abrupt decrease in cardiac function with subsequent evidence of recovery. 4) no evidence of an ischemic source of cardiac process.
one case was confirmed stress cardiomyopathy on post operative cardiac catheterization negative for ischemia. 7 cases were likely stress cardiomyopathy as evidenced by fulfilling all 4 criteria but without post operative cardiac catheterization confirming lack of ischemia.
Average pre-operatie Ejection Fraction (EF) on echocardiography was 60±/-3.6%. Post operative EF in setting of cardiomyopathy was 23.8±6.0% and echocardiogram demonstrating recovery showed mean EF of 52.9±7.9%. Mean peak troponin was 0.43±0.50ng/mL.
Conclusions: Stress cardiomyopathy after liver transplant surgery has seldom been reported but is increasingly being recognized as a source of post-operative cardiac dysfunction. The risk factors for development of this physiological phenomenon remain to be elucidated.
CITATION INFORMATION: Presser N, Barzilai B. Stress Cardiomyopathy in the Perio-Perative Period After Liver Transplant. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Presser N, Barzilai B. Stress Cardiomyopathy in the Perio-Perative Period After Liver Transplant. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/stress-cardiomyopathy-in-the-perio-perative-period-after-liver-transplant/. Accessed February 28, 2021.
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