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Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans.
Roehl, Anna Bettina; Hein, Marc; Kroencke, Johanna; Kork, Felix; Koch, Alexander; Andert, Anne; Becker, Michael; Schmöe, Jonas; Reinartz, Sebastian Daniel.
Affiliation
  • Roehl AB; Department of Anesthesiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Hein M; Department of Anesthesiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Kroencke J; Department of Anesthesiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Kork F; Department of Anesthesiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Koch A; Department of Internal Medicine III, Gastroenterology, Metabolic Diseases and Intensive Care, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Andert A; Department of General, Visceral and Transplantation Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Becker M; Department of Cardiology, Nephrology and Intensive Care, Rhein-Maas Hospital, 52146 Würselen, Germany.
  • Schmöe J; Department of Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
  • Reinartz SD; Department of Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
J Clin Med ; 10(21)2021 Nov 02.
Article in En | MEDLINE | ID: mdl-34768667
ABSTRACT

BACKGROUND:

The goal of cardiac evaluation of patients awaiting orthotopic liver transplantation (OLT) is to identify the patients at risk for cardiovascular events (CVEs) in the peri- and postoperative periods by opportunistic evaluation of coronary artery calcium (CAC) in non-gated abdominal computed tomographs (CT).

METHODS:

We hypothesized that in patients with OLT, a combination of Lee's revised cardiac index (RCRI) and CAC scoring would improve diagnostic accuracy and prognostic impact compared to non-invasive cardiac testing. Therefore, we retrospectively evaluated 169 patients and compared prediction of CVEs by both methods.

RESULTS:

Standard workup identified 22 patients with a high risk for CVEs during the transplant period, leading to coronary interventions. Eighteen patients had a CVE after transplant and a CAC score > 0. The combination of CAC and RCRI ≥ 2 had better negative (NPV) and positive predictive values (PPV) for CVEs (NPV 95.7%, PPV 81.6%) than standard non-invasive stress tests (NPV 92.0%, PPV 54.5%).

CONCLUSION:

The cutoff value of CAC > 0 by non-gated CTs combined with RCRI ≥ 2 is highly sensitive for identifying patients at risk for CVEs in the OLT population.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Prognostic_studies Language: En Journal: J Clin Med Year: 2021 Document type: Article Affiliation country: Publication country: CH / SUIZA / SUÍÇA / SWITZERLAND

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Prognostic_studies Language: En Journal: J Clin Med Year: 2021 Document type: Article Affiliation country: Publication country: CH / SUIZA / SUÍÇA / SWITZERLAND