Abstract 14374: Clinical and Echocardiographic Characteristics of Patients Who Develop Post Liver Transplant Non-Ischemic Cardiomyopathy

Abstract

Background: Non-ischemic cardiomyopathy is a well-known but poorly understood cardiac complication post orthotopic liver transplantation (OLT). Methods: We performed a nested case control study in a cohort of 590 patients who underwent OLT at Loma Linda University between 2013 - 2021. 29 (4.9%) patients developed post-OLT non-ischemic cardiomyopathy. 100 patients who did not develop cardiomyopathy were selected randomly from the cohort to serve as control group. Clinical characteristics of cases and controls were compared and echocardiograms of patients who developed cardiomyopathy reviewed. Results: Patients who developed cardiomyopathy were more likely to be female, less likely to have history of hypertension, had lower baseline hemoglobin and platelets, and higher MELD scores ( Table 1) . Mean pre-transplant ejection fraction (EF) was 69% among patients who developed cardiomyopathy. Cardiomyopathy developed on average 10 days after OLT with mean EF dropping to 26%. 24 (83%) patients had reduced EF (<40%) and 5 (17%) had mid-range EF (40-49%). Wall motion analysis revealed global hypokinesis in 11 (38%) patients, mid-ventricular takotsubo in 11 (38%) patients, apical takotsubo in 5 (17%) patients, and basal takotsubo in 2 (7%) patients (Figure 1) . 24 (83%) patients recovered EF (≥ 50%) on average of 113 days after initial diagnosis of cardiomyopathy. Conclusions: Female sex and higher MELD scores were associated with development of non-ischemic cardiomyopathy post OLT. Global hypokinesis and mid-ventricular takotsubo were the most common patterns of wall motion abnormality. EF recovery was noted in majority of patients indicating operative stress related etiology.