title: Prevalence of myocardial perfusion abnormalities in end-stage liver disease.
abstract: BACKGROUND
  The prevalence of coronary artery disease (CAD) in end-stage liver disease (ESLD) being evaluated for orthotopic liver transplantation (OLT) is unclear based on variable definition used for CAD.
  
  
  OBJECTIVE
  The aim of this study to investigate the prevalence of abnormal stress myocardial perfusion single-photon emission computed tomography (MPS) imaging, as a marker for CAD, among patients with ESLD who were referred for stress MPS imaging as a routine work up before OLT.
  
  
  METHODS
  This was a single-center, retrospective study. We reviewed data on 167 patients who were referred for MPS as a routine work up before OLT over the last 2 years. All patients underwent evaluation for CAD risk factors [age, hypercholesterolemia, diabetes mellitus (DM), hypertension (HTN), and smoking], and stress MPS as per standard protocol.
  
  
  RESULTS
  The total number of patients referred for stress MPS was 167. Seven patients (4% of total study population) were excluded from the study due to poor and/or nondiagnostic studies. 147 patients (92%) had normal, but only 13 patients (8%) had abnormal MPS scans. DM and male gender were the most independent risk factors for abnormal MPS with P value of 0.046, and 0.26, respectively. There was no significant association between the abnormal MPS result and HTN, hypercholesterolemia, smoking, age or etiology of the liver disease.
  
  
  CONCLUSIONS
  Based on our data, the prevalence of abnormal MPS and left ventricular ejection fraction in patients with ESLD was found to be 8%. DM and male gender were the most independent predictor factors for abnormal MPS. True prevalence of CAD and usefulness of MPS in patients with ESLD can only be studied using a very large and randomized prospective study.
authors.affiliation: Cardiovascular Imaging and Nuclear Medicine, Department of Medical Imaging Service, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ahm35799@hotmail.com
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fathala
authors.forename: Bander
authors.initials: B
authors.lastname: Safar
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al Muhaideb