Кореспондиращ автор: Лилия Демиревска ( liliya.demirevska72@gmail.com ) Академик редактор: Иван Груев © Лилия Демиревска, Ивайло Даскалов. Това е статия отворен достъп разпространява под условията на Creative Commons Attribution License (CC BY 4.0), която позволява използване без ограничения, разпространение, и възпроизвеждане на всякакъв носител, при условие на оригиналния автор и източник са кредитирани. Цитат:
Демиревска Л, Даскалов И (2020) Оценка на риска за коронарна артериална болест при кандидати за чернодробна трансплантация. Българска Кардиология 26(3): 7-16. https://doi.org/10.3897/bgcardio.26.e54743 |
Corresponding author: Liliya Demirevska ( liliya.demirevska72@gmail.com ) Academic editor: Ivan Gruev © Liliya Demirevska, Ivaylo Daskalov. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Citation:
Demirevska L, Daskalov I (2020) Coronary Artery Disease Risk Assessment of Liver Transplant Candidates. Bulgarian Cardiology 26(3): 7-16. https://doi.org/10.3897/bgcardio.26.e54743 |
Cardiovascular complications are a major cause of morbidity and mortality in patients with end-stage liver disease undergoing liver transplantation (LT). Coronary artery disease (CAD) contributes to major portion of cardiovascular complications and therefore warrants evaluation in the preoperative period. Patients awaiting LT are a special subgroup that carries heterogeneous risk factors and has unique pathogenic and clinical characteristics. These patients usually demonstrate increased cardiac output and a compromised response to stress. Low systemic vascular resistance and bradycardia are also commonly seen in cirrhosis and can be aggravated by beta-blocker use. Current non-invasive tests that assess for subclinical CAD have low sensitivity, and altered hemodynamics during the LT surgery can unmask latent cardiovascular disease either intraoperatively or in the immediate postoperative period. This review focuses on the expanding body of evidence for diagnosis and risk stratifi cation of CAD in LT candidates. The systematic approach to evaluate preoperative CAD risk in LT candidates may be helpful to optimize post-LT outcome.