Usefulness for Predicting Cardiac Events After Orthotopic Liver Transplantation of Myocardial Perfusion Imaging and Dobutamine Stress Echocardiography Preoperatively

David Snipelisky, Jordan Ray, Saraschandra Vallabhajosyula, Gautam Matcha, Samuel Squier, Jacob Lewis, Rex Holliday, Niti Aggarwal, J. Wells Askew, Brian P Shapiro, Nandan Anavekar

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Patients undergoing orthotopic liver transplantation have high rates of cardiac morbidity and mortality. Although guidelines recommend noninvasive stress testing as part of the preoperative evaluation, little data have evaluated clinical outcomes following orthotopic liver transplantation. A retrospective study at 2 high-volume liver transplantation centers was performed. All patients undergoing noninvasive stress testing (myocardial perfusion imaging [MPI] or dobutamine stress echocardiography [DSE]) over a 5-year period were included. Descriptive analyses, including clinical outcomes and perioperative and postoperative ischemic events, were performed. Comparisons were made between subsets of patients within each stress modality based on abnormal versus normal results. A total of 506 patients were included, of which 343 underwent DSE and 163 MPI. Few patients had abnormal results, with 19 (5.5%) in the DSE group and 13 (8%) in the MPI group. Perioperative and postoperative cardiac complications were low (n = 20, 5.8% and n = 3, 0.9% in DSE group and n = 15, 9.2% and n = 3, 1.8% in MPI group). Comparisons between abnormal versus normal findings showed a trend toward periprocedural cardiac complications in the abnormal DSE group (n = 3, 15.8% vs n = 17, 5.25%; p = 0.09) with no difference in 6-month postprocedural complications (n = 0 vs n = 3, 0.9%; p = 1.0). In the MPI group, a trend toward periprocedural ischemic complications (n = 3, 23.1% vs n = 12, 8%; p = 0.1) was noted with no difference in 6-month postprocedural complications (n = 0 vs n = 3, 2%; p = 1.0). In conclusion, our study found a significantly lower than reported cardiac event rate. In addition, it demonstrated that ischemic cardiac events are uncommon in patients with normal stress testing.

Original languageEnglish (US)
Pages (from-to)1008-1011
Number of pages4
JournalAmerican Journal of Cardiology
Volume119
Issue number7
DOIs
StatePublished - Apr 1 2017

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Stress Echocardiography
Myocardial Perfusion Imaging
Liver Transplantation
Retrospective Studies
Guidelines
Morbidity
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Usefulness for Predicting Cardiac Events After Orthotopic Liver Transplantation of Myocardial Perfusion Imaging and Dobutamine Stress Echocardiography Preoperatively. / Snipelisky, David; Ray, Jordan; Vallabhajosyula, Saraschandra; Matcha, Gautam; Squier, Samuel; Lewis, Jacob; Holliday, Rex; Aggarwal, Niti; Askew, J. Wells; Shapiro, Brian P; Anavekar, Nandan.

In: American Journal of Cardiology, Vol. 119, No. 7, 01.04.2017, p. 1008-1011.

Research output: Contribution to journalArticle

Snipelisky, D, Ray, J, Vallabhajosyula, S, Matcha, G, Squier, S, Lewis, J, Holliday, R, Aggarwal, N, Askew, JW, Shapiro, BP & Anavekar, N 2017, 'Usefulness for Predicting Cardiac Events After Orthotopic Liver Transplantation of Myocardial Perfusion Imaging and Dobutamine Stress Echocardiography Preoperatively', American Journal of Cardiology, vol. 119, no. 7, pp. 1008-1011. https://doi.org/10.1016/j.amjcard.2016.11.060
Snipelisky, David ; Ray, Jordan ; Vallabhajosyula, Saraschandra ; Matcha, Gautam ; Squier, Samuel ; Lewis, Jacob ; Holliday, Rex ; Aggarwal, Niti ; Askew, J. Wells ; Shapiro, Brian P ; Anavekar, Nandan. / Usefulness for Predicting Cardiac Events After Orthotopic Liver Transplantation of Myocardial Perfusion Imaging and Dobutamine Stress Echocardiography Preoperatively. In: American Journal of Cardiology. 2017 ; Vol. 119, No. 7. pp. 1008-1011.
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abstract = "Patients undergoing orthotopic liver transplantation have high rates of cardiac morbidity and mortality. Although guidelines recommend noninvasive stress testing as part of the preoperative evaluation, little data have evaluated clinical outcomes following orthotopic liver transplantation. A retrospective study at 2 high-volume liver transplantation centers was performed. All patients undergoing noninvasive stress testing (myocardial perfusion imaging [MPI] or dobutamine stress echocardiography [DSE]) over a 5-year period were included. Descriptive analyses, including clinical outcomes and perioperative and postoperative ischemic events, were performed. Comparisons were made between subsets of patients within each stress modality based on abnormal versus normal results. A total of 506 patients were included, of which 343 underwent DSE and 163 MPI. Few patients had abnormal results, with 19 (5.5{\%}) in the DSE group and 13 (8{\%}) in the MPI group. Perioperative and postoperative cardiac complications were low (n = 20, 5.8{\%} and n = 3, 0.9{\%} in DSE group and n = 15, 9.2{\%} and n = 3, 1.8{\%} in MPI group). Comparisons between abnormal versus normal findings showed a trend toward periprocedural cardiac complications in the abnormal DSE group (n = 3, 15.8{\%} vs n = 17, 5.25{\%}; p = 0.09) with no difference in 6-month postprocedural complications (n = 0 vs n = 3, 0.9{\%}; p = 1.0). In the MPI group, a trend toward periprocedural ischemic complications (n = 3, 23.1{\%} vs n = 12, 8{\%}; p = 0.1) was noted with no difference in 6-month postprocedural complications (n = 0 vs n = 3, 2{\%}; p = 1.0). In conclusion, our study found a significantly lower than reported cardiac event rate. In addition, it demonstrated that ischemic cardiac events are uncommon in patients with normal stress testing.",
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