Myocardial Performance after Successful Liver Transplantation

BACKGROUND: Myocardial performance index (MPI) or Tei index is a Doppler-derived index of combined systolic and diastolic myocardial function, calculated as the sum of isovolumetric relaxation time (IRT) and isovolumetric contraction time (ICT) divided by the ejection time (ET). OBJECTIVE: To evaluate the right and left ventricular systolic and diastolic function using MPI in children before and after liver transplantation. METHODS: A cross-sectional study was conducted on 30 children with liver cirrhosis before liver transplantation, 30 age-matched comparison group at least 6 months after liver transplantation, and 30 aged-matched children without history of heart disease in Nemazi Liver Transplant Center, Shiraz, Iran, from April 2012 to April 2014. Echocardiographic evaluation was carried out with a GE Vivid 3 echocardiographic machine, using a 3-MHz probe with tissue Doppler imaging (TDI) software using conventional and TDI method. RESULTS: The mean±SD left ventricle Tei index in patients was 0.33±0.02 before liver transplantation, 0.34±0.02 after liver transplantation, and 0.33±003 in the comparison group (p=0.36). The mean±SD right ventricular Tei index was 0.35±0.04 in patients before transplantation, 0.36±0.46 after liver transplantation, and 0.28±0.04 in the comparison group (p<0.001). In addition, when TDI was used, the mean±SD left ventricular Tei index was 0.39±0.50 in patients before transplantation, 0.37±0.42 after liver transplantation, and 0.38±006 in the comparison group (p=0.32). The tissue Doppler-derived Tei index for the right ventricle was 0.37±0.04 in patients before transplantation, 0.37±0.04 after liver transplantation, and 0.33±0.05 in the comparison group (p=0.031). The left ventricular Doppler-derived Tei index had a significant (p=0.03) correlation with Child-Turcotte-Pugh (CTP) score (r=0.57). CONCLUSION: Left ventricular MPI with Doppler echocardiography was correlated with CTP score. Right ventricular MPI was significantly increased in patients with cirrhosis and did not improve 6 months after transplantation.