Pronounced Coronary Arteriosclerosis in Cirrhosis: Influence on Cardiac Function and Survival?
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Pronounced Coronary Arteriosclerosis in Cirrhosis : Influence on Cardiac Function and Survival? / Danielsen, Karen V; Wiese, Signe; Hove, Jens; Bendtsen, Flemming; Møller, Søren.
I: Digestive Diseases and Sciences, Bind 63, Nr. 5, 2018, s. 1355-1362.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Pronounced Coronary Arteriosclerosis in Cirrhosis
T2 - Influence on Cardiac Function and Survival?
AU - Danielsen, Karen V
AU - Wiese, Signe
AU - Hove, Jens
AU - Bendtsen, Flemming
AU - Møller, Søren
PY - 2018
Y1 - 2018
N2 - BACKGROUND: The relation between excessive alcohol consumption and coronary arteriosclerosis has remained controversial. The etiology of cirrhosis has been considered a substantial risk factor for development of arteriosclerotic lesions. The coronary artery calcium-score derived from coronary CT angiography is a robust marker of coronary arteriosclerosis.AIMS: To study the burden of coronary arteriosclerosis in cirrhotic patients of various etiologies and association to cardiac dysfunction and survival.METHODS: Fifty-seven patients with cirrhosis without cardiovascular disease underwent coronary CT angiography, tissue Doppler echocardiography, electrocardiogram and registration of clinical and biochemical characteristics.RESULTS: In patients with cirrhosis the median coronary artery calcium-score was increased in comparison with age and race-adjusted healthy reference values (men: 328 vs. 9 HU and women: 136 vs. 0 HU; p < 0.001). Moreover, the coronary artery calcium-score in alcohol-related cirrhosis was significantly higher than in nonalcohol-related cirrhosis (362 vs. 46 HU, p < 0.001). Coronary artery calcium-score correlated with age (p = 0.002) but not with established cardiovascular risk factors including smoking, type 2 diabetes, hypertension, gender, or hypercholesterolemia. Coronary artery calcium-score was associated with diastolic dysfunction, lateral e´ (p = 0.025), but not with other markers of cardiac dysfunction. During a median follow-up of 25 months 12 patients (21%) died but coronary artery calcium-score was not associated with survival.CONCLUSIONS: Coronary arteriosclerosis was particular extensive in patients with alcoholic cirrhosis. However, the current results suggest that coronary arteriosclerosis only have limited influence on cardiac function and survival. Surprisingly, no other established risk factors apart from age seemed to interfere with coronary arteriosclerosis in cirrhotic patients.
AB - BACKGROUND: The relation between excessive alcohol consumption and coronary arteriosclerosis has remained controversial. The etiology of cirrhosis has been considered a substantial risk factor for development of arteriosclerotic lesions. The coronary artery calcium-score derived from coronary CT angiography is a robust marker of coronary arteriosclerosis.AIMS: To study the burden of coronary arteriosclerosis in cirrhotic patients of various etiologies and association to cardiac dysfunction and survival.METHODS: Fifty-seven patients with cirrhosis without cardiovascular disease underwent coronary CT angiography, tissue Doppler echocardiography, electrocardiogram and registration of clinical and biochemical characteristics.RESULTS: In patients with cirrhosis the median coronary artery calcium-score was increased in comparison with age and race-adjusted healthy reference values (men: 328 vs. 9 HU and women: 136 vs. 0 HU; p < 0.001). Moreover, the coronary artery calcium-score in alcohol-related cirrhosis was significantly higher than in nonalcohol-related cirrhosis (362 vs. 46 HU, p < 0.001). Coronary artery calcium-score correlated with age (p = 0.002) but not with established cardiovascular risk factors including smoking, type 2 diabetes, hypertension, gender, or hypercholesterolemia. Coronary artery calcium-score was associated with diastolic dysfunction, lateral e´ (p = 0.025), but not with other markers of cardiac dysfunction. During a median follow-up of 25 months 12 patients (21%) died but coronary artery calcium-score was not associated with survival.CONCLUSIONS: Coronary arteriosclerosis was particular extensive in patients with alcoholic cirrhosis. However, the current results suggest that coronary arteriosclerosis only have limited influence on cardiac function and survival. Surprisingly, no other established risk factors apart from age seemed to interfere with coronary arteriosclerosis in cirrhotic patients.
KW - Adolescent
KW - Adult
KW - Aged
KW - Computed Tomography Angiography
KW - Coronary Artery Disease/diagnostic imaging
KW - Cost of Illness
KW - Echocardiography, Doppler
KW - Electrocardiography
KW - Female
KW - Follow-Up Studies
KW - Heart/diagnostic imaging
KW - Humans
KW - Liver Cirrhosis/complications
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Risk Factors
KW - Young Adult
U2 - 10.1007/s10620-018-5006-7
DO - 10.1007/s10620-018-5006-7
M3 - Journal article
C2 - 29516327
VL - 63
SP - 1355
EP - 1362
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
SN - 0163-2116
IS - 5
ER -
ID: 215457495