背景：该研究的目的在于研究肝移植对于心脏的影响，并分析其与相关临床因素、超声心动图和血液动力学改变的关系。方法：1998年至2004年所有因肝硬化行肝移植的患者均入选该研究。我们分析了这些患者的临床数据、超声心动图、肝脏血液动力学以及右心的血液动力学。在行肝移植手术期间，这些患者行持续右心压力监测。开放血流后监测10分钟，比较其与基线值。非正常心脏反应定义为肺毛细血管楔压增高但是左室搏出作功指数下降。采用logistic回归分析非正常心脏反应的预测作用。结果：209例受者（平均年龄52岁，Child A 27; B 93; C 89）平均终末期肝病模型评分为16.3（4.7）。在开放血流后，有47例（22.5%）患者出现非正常心脏反应。发生这些反应的患者存在低钠血症、更低的中心静脉压、更低的肺动脉压和更低的肺毛细血管楔压。非正常的心脏反应还与手术后更长时间的气管插管相关。结果：在肝移植手术期间能够观察到非正常的心脏反应，且可能是隐匿性硬化性心肌病的表现。使用常规诊断手段可能会掩盖上述改变，可能是进行性肝病患者循环功能不全的非直接体征。

BACKGROUND.: The aim was to investigate the cardiac response during liver transplantation (LT) and analyze its relationship with clinical factors, echocardiographic, and hemodynamic findings. METHODS.: All patients undergoing LT for cirrhosis from 1998 to 2004 were included. Clinical data, comprehensive echocardiography, hepatic, and right heart hemodynamic measurements were analyzed. During LT patients underwent continuous right-heart pressure monitorization. Measurements 10 min after reperfusion were compared with baseline values. Abnormal cardiac response was defined as a decrease in left ventricular stroke work index despite a rise in pulmonary wedge capillary pressure. Predictors of abnormal cardiac response were investigated using logistic regression. RESULTS.: Data were available from 209 patients (mean age 52 (9) yrs; Child A 27; B 93; C 89) with a mean model for end-stage liver disease score 16.3 (4.7). Abnormal cardiac response was observed in 47 (22.5%) patients after reperfusion. Patients who developed this response had hyponatremia, lower central venous pressure, lower pulmonary artery pressure, and lower pulmonary wedged capillary pressure. Abnormal cardiac response was related to a longer postoperative intubation time. CONCLUSION.: Abnormal cardiac response is observed during LT and may be a manifestation of occult cirrhotic cardiomyopathy. This finding is underestimated with usual diagnostic tools and could be related to indirect signs of circulatory dysfunction of advanced liver disease.