Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do

Non-alcoholic fatty liver disease (NAFLD) is increasing considerably due to the current lifestyle, which means that it is becoming one of the main indications for liver transplantation. On the other hand, there is a strong association between NAFLD and cardiovascular disease. This has been evidenced...

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Autores principales: Sanchez-Torrijos, Yolanda, Ampuero, Javier, Romero-Gómez, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440773/
https://www.ncbi.nlm.nih.gov/pubmed/28596817
http://dx.doi.org/10.4254/wjh.v9.i15.697
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author Sanchez-Torrijos, Yolanda
Ampuero, Javier
Romero-Gómez, Manuel
author_facet Sanchez-Torrijos, Yolanda
Ampuero, Javier
Romero-Gómez, Manuel
author_sort Sanchez-Torrijos, Yolanda
collection PubMed
description Non-alcoholic fatty liver disease (NAFLD) is increasing considerably due to the current lifestyle, which means that it is becoming one of the main indications for liver transplantation. On the other hand, there is a strong association between NAFLD and cardiovascular disease. This has been evidenced in many studies revealing a higher presence of carotid plaques or carotid intima-media thickness, leading to cardiovascular events and, ultimately, mortality. According to the liver transplant guidelines, screening for heart disease in transplant candidates should be performed by electrocardiogram and transthoracic echocardiography while a stress echocardiogram should be reserved for those with more than two cardiovascular risk factors or greater than 50 years old. However, there are no specific recommendations in NAFLD patients requiring a liver transplantation, despite its well-known cardiovascular risk association. Many studies have shown that these patients probably require a more exhaustive assessment and a global approach including other specialists such as cardiologists or nutritionists. Also, the incidence of cardiovascular disease is also increased in NAFLD patients in the post-transplantation period in comparison with other etiologies, because of the pre-existent risk factors together with the immunosuppressive therapy. Therefore, an early intervention on the lifestyle and the individualized selection of the immunosuppressive regimen could lead to a modification of the cardiovascular risk factors in NAFLD patients requiring a liver transplantation.
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spelling pubmed-54407732017-06-09 Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do Sanchez-Torrijos, Yolanda Ampuero, Javier Romero-Gómez, Manuel World J Hepatol Minireviews Non-alcoholic fatty liver disease (NAFLD) is increasing considerably due to the current lifestyle, which means that it is becoming one of the main indications for liver transplantation. On the other hand, there is a strong association between NAFLD and cardiovascular disease. This has been evidenced in many studies revealing a higher presence of carotid plaques or carotid intima-media thickness, leading to cardiovascular events and, ultimately, mortality. According to the liver transplant guidelines, screening for heart disease in transplant candidates should be performed by electrocardiogram and transthoracic echocardiography while a stress echocardiogram should be reserved for those with more than two cardiovascular risk factors or greater than 50 years old. However, there are no specific recommendations in NAFLD patients requiring a liver transplantation, despite its well-known cardiovascular risk association. Many studies have shown that these patients probably require a more exhaustive assessment and a global approach including other specialists such as cardiologists or nutritionists. Also, the incidence of cardiovascular disease is also increased in NAFLD patients in the post-transplantation period in comparison with other etiologies, because of the pre-existent risk factors together with the immunosuppressive therapy. Therefore, an early intervention on the lifestyle and the individualized selection of the immunosuppressive regimen could lead to a modification of the cardiovascular risk factors in NAFLD patients requiring a liver transplantation. Baishideng Publishing Group Inc 2017-05-28 2017-05-28 /pmc/articles/PMC5440773/ /pubmed/28596817 http://dx.doi.org/10.4254/wjh.v9.i15.697 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Minireviews
Sanchez-Torrijos, Yolanda
Ampuero, Javier
Romero-Gómez, Manuel
Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do
title Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do
title_full Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do
title_fullStr Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do
title_full_unstemmed Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do
title_short Cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: What we do, what we should do
title_sort cardiovascular assessment in liver transplant for non-alcoholic steatohepatitis patients: what we do, what we should do
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440773/
https://www.ncbi.nlm.nih.gov/pubmed/28596817
http://dx.doi.org/10.4254/wjh.v9.i15.697
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