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Journal ArticleDOI

Evaluation of coronary artery disease in potential liver transplant recipients.

01 Mar 2017-Liver Transplantation (John Wiley & Sons, Ltd)-Vol. 23, Iss: 3, pp 386-395
TL;DR: In assessing LT recipients, a management paradigm of “quadruple assessment” is suggested to include (1) history, examination, and electrocardiogram; (2) transthoracic echocardiograms; (3) functional testing; and (4) where appropriate, direct assessment of CAD.
About: This article is published in Liver Transplantation.The article was published on 2017-03-01 and is currently open access. It has received 52 citations till now. The article focuses on the topics: Liver transplantation & Coronary artery disease.
Citations
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Journal ArticleDOI
TL;DR: A critical assessment of the diagnosis of cardiac and pulmonary vascular disease and interventions aimed at managing these conditions in LT candidates is provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.

111 citations

Journal ArticleDOI
TL;DR: The current review article discusses as to which patients with NAFLD to screen and how to screen for CVD, and there is sparse literature regarding the screening forCVD in patients withNAFLD.
Abstract: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Patients with NAFLD are at a higher risk of developing cardiovascular disease (CVD). In fact, CVD-related mortality is more common in patients with NAFLD in comparison to liver-related mortality. This association is related to the common metabolic risk factors such as obesity, dyslipidemia, diabetes, and hypertension shared by both NAFLD and CVD, and also there is independent association of NAFLD with CVD because of risk factors such as insulin resistance, systemic inflammation, and atherogenic dyslipidemia. While there is abundant literature on association of NAFLD with CVD, there is sparse literature regarding the screening for CVD in patients with NAFLD. In the current review article, we discuss as to which patients with NAFLD to screen and how to screen for CVD.

38 citations

Journal ArticleDOI
TL;DR: This screening protocol for performing CATH based upon predefined risk factors, rather than noninvasive testing alone, is applied to a larger cohort (2010‐2016) to assess post‐LT clinical outcomes.

28 citations


Cites background from "Evaluation of coronary artery disea..."

  • ...(2) Despite these recommendations, there is a large degree of variation between clinical practice guidelines and transplant center practice patterns with regard to who should be screened for CAD and which screening modality should be used.(4,5) Moreover, the clinical utility of screening asymptomatic transplant candidates remains unclear....

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Journal ArticleDOI
TL;DR: The management of the components of metabolic syndrome following liver transplantation is discussed and practical stepwise guidance is provided and the need for adequately powered studies for the treatment of metabolic comorbidities in liver transplant recipients is emphasised.

28 citations

Journal ArticleDOI
TL;DR: In conclusion, negative CTCA finding in suspected patients can successfully exclude post‐LT MI, whereas proceeding with invasive angiography is needed to further risk‐stratify in patients with significant C TCA‐diagnosed CAD.

22 citations

References
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Journal ArticleDOI
TL;DR: The 2011 Compendium is an update of a system for quantifying the energy cost of adult human PA and is a living document that is moving in the direction of being 100% evidence based.
Abstract: Purpose:The Compendium of Physical Activities was developed to enhance the comparability of results across studies using self-report physical activity (PA) and is used to quantify the energy cost of a wide variety of PA. We provide the second update of the Compendium, called the 2011 Compend

4,712 citations

Journal ArticleDOI
TL;DR: The 2017-18 FACC/FAHA curriculum vitae will focus on adolescent and young adult FACC and FAHA education, as well as leadership, self-confidence, and self-consistency.
Abstract: Jeffrey L. Anderson, MD, FACC, FAHA, Chair Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect Nancy M. Albert, PhD, RN, FAHA Biykem Bozkurt, MD, PhD, FACC, FAHA Ralph G. Brindis, MD, MPH, MACC Lesley H. Curtis, PhD, FAHA David DeMets, PhD[¶¶][1] Lee A. Fleisher, MD, FACC, FAHA Samuel

2,291 citations

Journal ArticleDOI
TL;DR: CPX offers the clinician the ability to obtain a wealth of information beyond standard exercise electrocardiography testing that when appropriately applied and interpreted is underutilized by the practicing clinician.
Abstract: Exercise testing remains a remarkably durable and versatile tool that provides valuable diagnostic and prognostic information regarding patients with cardiovascular and pulmonary disease. Exercise testing has been available for more than a half century and, like many other cardiovascular procedures, has evolved in its technology and scope. When combined with exercise testing, adjunctive imaging modalities offer greater diagnostic accuracy, additional information regarding cardiac structure and function, and additional prognostic information. Similarly, the addition of ventilatory gas exchange measurements during exercise testing provides a wide array of unique and clinically useful incremental information that heretofore has been poorly understood and underutilized by the practicing clinician. The reasons for this are many and include the requirement for additional equipment (cardiopulmonary exercise testing [CPX] systems), personnel who are proficient in the administration and interpretation of these tests, limited or absence of training of cardiovascular specialists and limited training by pulmonary specialists in this technique, and the lack of understanding of the value of CPX by practicing clinicians. Modern CPX systems allow for the analysis of gas exchange at rest, during exercise, and during recovery and yield breath-by-breath measures of oxygen uptake (Vo2), carbon dioxide output (Vco2), and ventilation (Ve). These advanced computerized systems provide both simple and complex analyses of these data that are easy to retrieve and store, which makes CPX available for widespread use. These data can be readily integrated with standard variables measured during exercise testing, including heart rate, blood pressure, work rate, electrocardiography findings, and symptoms, to provide a comprehensive assessment of exercise tolerance and exercise responses. CPX can even be performed with adjunctive imaging modalities for additional diagnostic assessment. Hence, CPX offers the clinician the ability to obtain a wealth of information beyond standard exercise electrocardiography testing that when appropriately applied and interpreted …

1,510 citations

Journal ArticleDOI
TL;DR: The Duke Activity Status Index is a valid measure of functional capacity that can be obtained by self-administered questionnaire and correlated well with peak oxygen uptake.
Abstract: To develop a brief, self-administered questionnaire that accurately measures functional capacity and assesses aspects of quality of life, 50 subjects undergoing exercise testing with measurement of peak oxygen uptake were studied. All subjects were questioned about their ability to perform a variety of common activities by an interviewer blinded to exercise test findings. A 12-item scale (the Duke Activity Status Index) was then developed that correlated well with peak oxygen uptake (Spearman correlation coefficient 0.80). To test this new index, an independent group of 50 subjects completed a self-administered questionnaire to determine functional capacity and underwent exercise testing with measurement of peak oxygen uptake. The Duke Activity Status Index correlated significantly (p less than 0.0001) with peak oxygen uptake (Spearman correlation coefficient 0.58) in this independent sample. The Duke Activity Status Index is a valid measure of functional capacity that can be obtained by self-administered questionnaire.

1,457 citations


"Evaluation of coronary artery disea..." refers methods in this paper

  • ...Self-administered questionnaires, such as the Duke Activity Status Index, have shown good correlation with functional CV testing but are not widely used.((26)) A 12-lead electrocardiogram is essential, prolongation of the QTc interval has been associated with cirrhotic cardiomyopathy, and a QTc interval of >440 ms is associated with a significantly reduced survival rate....

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Journal ArticleDOI
TL;DR: These CPGs, based on systematic methods to evaluate and classify evidence, provide a cornerstone of quality quality clinical practice guidelines (CPGs) with recommendations to standardize and improve cardiovascular health.
Abstract: Preamble 2216 1 Introduction 2217 2 Clinical Risk Factors: Recommendations 2220 3 Approach to Perioperative Cardiac Testing 2221 4 Supplemental Preoperative Evaluation: Recommendations 2221 5 Perioperative Therapy: Recommendations 2224 6 Anesthetic Consideration and Intraoperative Management: Recommendations 2228 7 Surveillance and Management for Perioperative MI: Recommendations 2229 8 Future Research Directions 2230 Appendix 1 Author Relationships With Industry and Other Entities (Relevant) 2237 Appendix 2 Reviewer Relationships With Industry and Other Entities (Relevant) 2239 Appendix 3 Related Recommendations From Other CPGs 2244 References 2230 The American College of Cardiology (ACC) and the American Heart Association (AHA) are committed to the prevention and management of cardiovascular diseases through professional education and research for clinicians, providers, and patients Since 1980, the ACC and AHA have shared a responsibility to translate scientific evidence into clinical practice guidelines (CPGs) with recommendations to standardize and improve cardiovascular health These CPGs, based on systematic methods to evaluate and classify evidence, provide a cornerstone of quality …

640 citations

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