Noninvasive visualization of coronary calcinosis in patients with chronic terminal hepatopathy

Abstract

Dynamics of a coronary artery calcium index as a factor of a cardiovascular risk in chronic terminal hepatopathy patients who need transplantation is determined. A prospective single-center cohort study was done and included 250 patients who need liver transplantation. The observation time was 5.4 ± 3.29 years from the moment of putting a patient on the waiting list. In addition to the assessment of occurrence and dynamics of traditional cardiovascular risk factors, calcium index indicators were determined by the method of multispiral computer tomography at the stage of including a patient into the study and after fve years of dynamic monitoring. The calcium index indicator in chronic terminal hepatopathy patients who need transplantation exceeded the limits of the recommended norm defned by a value of the 75th percentile, in 56.3 % (n = 152) of the examined patients at the stage of putting them on the waiting list. While comparing the coronary calcinosis indicators after fve years of dynamic monitoring the recipients of the liver transplants showed higher values of the calcium index in comparison with the patients with chronic terminal hepatopathy who did not receive the donor organ (CI, AJ-130 – 223 (38; 597) and 141 (4; 176) units respectively, p < 0.05; CI, Volume-130 – 314 (73; 748) and 203 (8; 284) mm2, respectively, p < 0.01), and the patients with metabolic syndrome (CI, AJ-130 – 186 (78; 463) and 74 (21; 192) units respectively, p < 0.01; CI, Volume-130 – 278 (74; 623) and 124 (74; 273) mm2 respectively, p < 0.01) and/or ischemic heart disease (CI, AJ-130 – 274 (102; 683) and 109 (34; 246) units respectively, p < 0.01; CI, Volume-130 – 382 (98; 834) and 382 (98; 834) mm2 respectively, p < 0.01) from the overall population. The obtained results make it possible to suppose that in addition to the radical solution to the liver defciency problem, the performance of orthotopic liver transplantations on patients with chronic terminal diseases accelerates the development of coronary atherosclerosis in the long-term postoperative period.