Abstract
Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.
| Original language | English |
|---|---|
| Journal | Digestive and Liver Disease |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
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Keywords
- Carotid IMT
- EAT
- OLT
- Visceral adiposity atherosclerosis
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
Cite this
High prevalence of early atherosclerotic and cardiac damage in patients undergoing liver transplantation : Preliminary results. / Pisano, Giuseppina; Donato, Maria Francesca; Consonni, Dario; Oberti, Giovanna; Borroni, Vittorio; Lombardi, Rosa; Invernizzi, Federica; Bertelli, Cristina; Caccamo, Lucio; Porzio, Marianna; Dondossola, Daniele; Rossi, Giorgio; Fargion, Silvia; Fracanzani, Anna Ludovica.
In: Digestive and Liver Disease, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High prevalence of early atherosclerotic and cardiac damage in patients undergoing liver transplantation
T2 - Preliminary results
AU - Pisano, Giuseppina
AU - Donato, Maria Francesca
AU - Consonni, Dario
AU - Oberti, Giovanna
AU - Borroni, Vittorio
AU - Lombardi, Rosa
AU - Invernizzi, Federica
AU - Bertelli, Cristina
AU - Caccamo, Lucio
AU - Porzio, Marianna
AU - Dondossola, Daniele
AU - Rossi, Giorgio
AU - Fargion, Silvia
AU - Fracanzani, Anna Ludovica
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.
AB - Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.
KW - Carotid IMT
KW - EAT
KW - OLT
KW - Visceral adiposity atherosclerosis
UR - http://www.scopus.com/inward/record.url?scp=85071991486&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071991486&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2019.07.007
DO - 10.1016/j.dld.2019.07.007
M3 - Article
AN - SCOPUS:85071991486
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
ER -