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Prevalence of myocardial perfusion abnormalities in end-stage liver disease

Ahmed Fathala1, Bander Safar, Ahmed Al Muhaideb

  • 1Cardiovascular Imaging and Nuclear Medicine, Department of Medical Imaging Service, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ahm35799@hotmail.com

Indian Journal of Nuclear Medicine : IJNM : the Official Journal of the Society of Nuclear Medicine, India
|October 5, 2011
PubMed

Insights

The prevalence of abnormal myocardial perfusion scans (MPS) in end-stage liver disease (ESLD) patients awaiting liver transplantation is 8%. Diabetes and male gender are key predictors of abnormal MPS results, indicating potential coronary artery disease (CAD).

Area of Science:

  • Cardiology
  • Hepatology
  • Nuclear Medicine

Background:

  • Coronary artery disease (CAD) prevalence in end-stage liver disease (ESLD) patients undergoing evaluation for orthotopic liver transplantation (OLT) is not well-defined.
  • Variable definitions for CAD contribute to the uncertainty regarding its prevalence in ESLD.

Purpose of the Study:

  • To determine the prevalence of abnormal stress myocardial perfusion single-photon emission computed tomography (MPS) imaging as a marker for CAD in ESLD patients.
  • To assess the utility of MPS as a routine pre-OLT workup for identifying CAD in this population.

Main Methods:

  • A retrospective, single-center study reviewed data from 167 patients referred for stress MPS imaging before OLT.
  • Patients were evaluated for traditional CAD risk factors including diabetes mellitus (DM), hypertension (HTN), hypercholesterolemia, age, and smoking status.
  • Stress MPS was performed according to standard protocols.

Main Results:

  • Out of 167 patients, 13 (8%) had abnormal MPS scans, while 147 (92%) had normal scans after excluding 7 non-diagnostic studies.
  • Diabetes mellitus (DM) and male gender were identified as independent predictors of abnormal MPS (P=0.046 and P=0.26, respectively).
  • No significant association was found between abnormal MPS and HTN, hypercholesterolemia, smoking, age, or liver disease etiology.

Conclusions:

  • The prevalence of abnormal MPS, indicative of potential CAD, in ESLD patients evaluated for OLT is 8%.
  • DM and male gender are significant independent predictors for abnormal MPS in this cohort.
  • Further large-scale, randomized prospective studies are necessary to definitively establish the true prevalence of CAD and the role of MPS in ESLD patients awaiting OLT.
Abstract

Keywords:
End stage liver diseasecoronary artery diseasemyocardial perfusion SPECT

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