studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 941A
and dry BMI, mid-arm muscle circumference, SMI and VMI.
Logistic regression analysis revealed that INR [O.R. 6.581
(95% C.I. 1.330 – 32.569), p = 0.021] and log-transformed
leptin [O.R. 0.425 (0.221 – 0.816), p < 0.010] were independently
associated with malnutrition. Conclusions: Low serum
leptin and elevated INR are associated with malnutrition in hospitalized
patients with cirrhosis and may represent biomarkers
for early identification of malnutrition in this population.
Disclosures:
The following authors have nothing to disclose: Vikrant Rachakonda, Jaideep
Behari
Disclosures:
Lewis R. Roberts - Grant/Research Support: Bristol Myers Squibb, ARIAD Pharmaceuticals,
BTG, Wako Diagnostics, Inova Diagnostics, Gilead Sciences, Five
Prime Therapeutics
The following authors have nothing to disclose: Thoetchai Peeraphatdit, Niyada
Naksuk, Roongruedee Chaiteerakij
1497
The World Congress of Gastroenterology Guidelines for
the Diagnosis of Left Ventricular Diastolic Dysfunction
Differ from the American Society of Echocardiography
Standard Recommendation
Thoetchai Peeraphatdit 1,2 , Niyada Naksuk 3 , Lewis R. Roberts 2 ,
Roongruedee Chaiteerakij 2,4 ; 1 Internal Medicine, University of
Minnesota, Minneapolis, MN; 2 Gastroenterology and Hepatology,
Mayo Clinic College of Medicine, Rochester, MN; 3 Cardiovascular
Diseases, Mayo Clinic College of Medicine, Rochester,
MN; 4 Medicine, Chulalongkorn University, Bangkok, Thailand
Purpose: Diagnostic criteria for left ventricular diastolic dysfunction
(LVDD) proposed by the World Congress of Gastroenterology
(WCG) has never been tested and are different from
the American Society of Echocardiography (ASE) criteria. This
study determined the agreement of LVDD diagnosed by these
two guidelines, the performance of the WCG criteria, and
their prognostic values. Methods: We retrospectively enrolled
914 consecutive patients with normal left ventricular ejection
fraction (LVEF) and available data on diastolic function undergoing
liver transplant (LT) at a tertiary medical center between
1994 and 2014. According to the ASE, LVDD was diagnosed
based on a stepwise approach using multiple parameters.
However, by the WCG, LVDD was defined as an early to
late ventricular filling velocities ratio (E/A) 200 ms. The agreement of LVDD diagnosed by
the two guidelines was analyzed using the Kappa statistic.
The performance of the WCG criteria was determined using
the ASE criteria as a gold standard. Results: Mean age was
53.7±10.6 years; 65.2% were male. During 5.6±4.2 years
follow up after LT, 21.6% patients had died. Overall LVEF was
65.8±5.1%. By the ASE criteria, 47.2% of patients had LVDD;
whereas the prevalence of LVDD was 19.6%, 61.0%, 64.5%
and 13.9% by the WCG criteria of E/A 200 ms,
either one of the criteria, or both criteria, respectively. There
was minimal agreement between LVDD diagnosed by the 2
WCG criteria (Kappa=0.10). Moreover, there was generally
poor or slight agreement between the ASE and the WCG criteria
(Kappa=0.08-0.18, Table). The WCG criteria had sensitivities
of 50-70% and specificities of 58-62% (Table). However,
in the multivariate Cox regression, only LVDD diagnosed by
the WCG criterion of E/A