Donovan Robert J, Choi Calvin, Ali Asghar, Heuman Douglas M, Fuchs Michael, Bavry Anthony A, Jovin Ion S
Department of Medicine, Virginia Commonwealth University, McGuire VAMC, Richmond, VA, USA.
Department of Medicine, Randall VAMC, University of Florida, Gainesville, FL, USA.
Dig Dis Sci. 2017 Jan;62(1):26-34. doi: 10.1007/s10620-016-4371-3. Epub 2016 Nov 9.
Patients with advanced liver disease have a high prevalence of cardiovascular risk factors, but many of them are asymptomatic. Cardiovascular risk stratification prior to liver transplant can be done by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computer tomography, and coronary angiography, but there are no clear recommendations regarding what method should be used and who should be screened. Because of this and because of inherent risk profile in this population, the variations in practice are significant. Careful screening and rigorous management of cardiovascular risk factors are important to ensure optimal cardiovascular outcomes in the immediate post-transplantation period and in the long term as well.
晚期肝病患者心血管危险因素的患病率很高，但其中许多人没有症状。肝移植前的心血管风险分层可以通过多巴酚丁胺负荷超声心动图、负荷心肌灌注成像、心脏计算机断层扫描和冠状动脉造影来进行，但对于应使用何种方法以及哪些人应接受筛查，尚无明确建议。由于这一点以及该人群固有的风险特征，实际操作中的差异很大。仔细筛查和严格管理心血管危险因素对于确保移植后即刻以及长期的最佳心血管结局都很重要。
