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

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 compu...

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Autores principales:	Anna Bettina Roehl, Marc Hein, Johanna Kroencke, Felix Kork, Alexander Koch, Anne Andert, Michael Becker, Jonas Schmöe, Sebastian Daniel Reinartz
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	orthotopic liver transplantation cardiac assessment coronary calcium score coronary artery disease stress testing Medicine R
Acceso en línea:	https://doaj.org/article/771c9bc13e53467bb84da0231601d21a
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spelling	oai:doaj.org-article:771c9bc13e53467bb84da0231601d21a2021-11-11T17:46:06ZCardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans10.3390/jcm102151482077-0383https://doaj.org/article/771c9bc13e53467bb84da0231601d21a2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5148https://doaj.org/toc/2077-0383Background: 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.Anna Bettina RoehlMarc HeinJohanna KroenckeFelix KorkAlexander KochAnne AndertMichael BeckerJonas SchmöeSebastian Daniel ReinartzMDPI AGarticleorthotopic liver transplantationcardiac assessmentcoronary calcium scorecoronary artery diseasestress testingMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5148, p 5148 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	orthotopic liver transplantation cardiac assessment coronary calcium score coronary artery disease stress testing Medicine R
spellingShingle	orthotopic liver transplantation cardiac assessment coronary calcium score coronary artery disease stress testing Medicine R Anna Bettina Roehl Marc Hein Johanna Kroencke Felix Kork Alexander Koch Anne Andert Michael Becker Jonas Schmöe Sebastian Daniel Reinartz Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
description	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.
format	article
author	Anna Bettina Roehl Marc Hein Johanna Kroencke Felix Kork Alexander Koch Anne Andert Michael Becker Jonas Schmöe Sebastian Daniel Reinartz
author_facet	Anna Bettina Roehl Marc Hein Johanna Kroencke Felix Kork Alexander Koch Anne Andert Michael Becker Jonas Schmöe Sebastian Daniel Reinartz
author_sort	Anna Bettina Roehl
title	Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
title_short	Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
title_full	Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
title_fullStr	Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
title_full_unstemmed	Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
title_sort	cardiovascular evaluation of liver transplant patients by using coronary calcium scoring in ecg-synchronized computed tomographic scans
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/771c9bc13e53467bb84da0231601d21a
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Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans

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