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. 2021 Nov 2;10(21):5148.
doi: 10.3390/jcm10215148.

Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans

Anna Bettina Roehl  1 , Marc Hein  1 , Johanna Kroencke  1 , Felix Kork  1 , Alexander Koch  2 , Anne Andert  3 , Michael Becker  4 , Jonas Schmöe  5 , Sebastian Daniel Reinartz  5
Affiliations

Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans

Anna Bettina Roehl et al. J Clin Med. .

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.

Keywords: cardiac assessment; coronary artery disease; coronary calcium score; orthotopic liver transplantation; stress testing.

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Conflict of interest statement

The authors declare no conflict of interest.

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