Takotsubo cardiomyopathy following liver transplantation: A multicenter cohort study

作者：Abraham J. Matar, James Keiler, Alexandra C. Bolognese, Arielle Cimeno, Colin D. Whitmore, Chase J. Wehrle, Federico Aucejo, Ekaterina Fedorova, David D. Aufhauser, Ram Subramanian, Marwan Kazimi, Valmiki Maharaj, Elizabeth S. Aby, Joseph F. Magliocca, Steven C. Kim · 发表于：Liver Transplantation · 年份：2024 · DOI：10.1097/lvt.0000000000000503 · 被引用次数：2 · 研究领域：Takotsubo Cardiomyopathy and Associated Phenomena、Neurological Complications and Syndromes、Cardiovascular Issues in Pregnancy

Takotsubo cardiomyopathy (TCM) is an acute, stress-mediated, reversible cardiomyopathy that occurs in the absence of hemodynamically significant coronary artery disease. We aimed to investigate the characteristics and outcomes of patients who developed TCM following liver transplantation (LT) in a multicenter study. Adult patients from 6 centers across the United States who developed TCM according to Mayo Clinic criteria following LT between 2008 and 2023 were included. Demographics, perioperative and long-term outcomes, and treatment modalities were assessed. Fifty-five patients were included. The center incidence of TCM ranged from 0.1% to 0.5%. The majority were female (54.5%) and Caucasian (87.2%), and the median age at transplant was 59 years. The primary etiologies for LT were alcohol-associated cirrhosis (49.1%) and metabolic dysfunction-associated steatotic liver disease cirrhosis (21.8%). The median time from LT to TCM diagnosis was 4 days. TCM was associated with a 60.9% reduction in left ventricular ejection fraction (LVEF) from a pretransplant median LVEF of 64.0%-25.0%. The most common treatment for TCM was diuretics (67.3%) and afterload reduction (54.5%), with only 27.3% of patients requiring vasopressor support. At a median follow-up of 31.5 months, 1-year and 3-year overall survivals (OSs) were 86.3% and 69.4%, respectively. A repeat echocardiogram performed at a median of 84 days demonstrated that 45/55 patients (81.8%) had recovered LVEF ≥50%. Patients with...