Endothelium Dysfunction as a Risk Factor of Ischemic Heart Disease in Liver Transplant Recipients

For citation: Grigorenko E.A., Mitkovskaya N.P., Rummo O.O. Endothelium Dysfunction as a Risk Factor of Ischemic Heart Disease in Liver Transplant Recipients. Doctor.Ru. 2020; 19(5): 30–34. (in Russian) DOI: 10.31550/1727-2378-2020-19-5-30-34
22 july 2020

Study Objective: taking into account the contribution of the endothelium dysfunctions into pathogenesis of chronic ischemic heart disease (IHD), the objective was to assess the serum level of endothelium dysfunction-specific biomarkers in liver transplant recipients during the immediate and long-term post-surgery periods.

Study Design: prospective single-site cohort study.

Materials and Methods. The study enrolled 420 liver transplant recipients. The follow-up lasted for 5.3 ± 2.34 years. Depending on presence/absence of the recorded event (chronic IHD) during the long-term post-surgery period, the test cohort was divided into two groups: IHD+ (n = 102) and IHD– (n = 318). Endothelium-dependant arteria brachialis vasodilatation (reactive hyperemia test) and endothelium function biomarker levels were studied.

Study Results. In liver transplant recipients, chronic IHD development during the follow-up of 5.3 ± 2.34 years was accompanied by the raise in the levels of nitrogen oxide metabolites, endothelin 1, homocysteine, inter-cellular adhesion molecules VCAM-1, and ICAM-1, as well as by decreased endothelium-dependant vasodilatation.

Conclusion. It is demonstrated that orthotopic liver transplantation cannot reduce the overall cardiovascular risk and endothelium dysfunction risk in particular; thus, diagnostic search is essential for early IHD detection in this group of patients during the long-term post-surgery period.

Contributions: Mitkovskaya, N.P. — concept and study protocol, results discussion, data analysis and interpretation, initial manuscript completion; Rummo, O.O. — patient setting and data collection arrangements, results discussion, data analysis and interpretation; Grigorenko, E.A. — concept and study protocol, outcome recording, assessment of endothelium function biomarker levels and endothelium-dependant arteria brachialis vasodilatation (reactive hyperemia test), data analysis and interpretation, initial manuscript, initial manuscript completion.

Conflict of interest: The authors declare that they do not have any conflict of interests.

Source of funding: The study was conducted with the 2020 government grant from the President of the Republic of Belarus for development and implementation of new organisational forms into practical medicine, for improvement of follow-up care of liver and kidney transplant recipients to enhance the efficiency of primary and secondary prevention of cardiovascular complications in these patients.

E.A. Grigorenko — Belarusian State Medical University; 83 Dzerzhinsky Prosp., Minsk, Republic of Belarus 220116. ORCID: https://orcid.org/0000-0002-8120-6267. E-mail: alegri@tut.by

N.P. Mitkovskaya (Corresponding author) — Belarusian State Medical University; 83 Dzerzhinsky Prosp., Minsk, Republic of Belarus 220116. ORCID: https://orcid.org/0000-0002-9088-721X. E-mail: mitkovskaya1@mail.ru

O.O. Rummo — Minsk Scientific and Practical Centre of Surgery, Transplantology and Hematology; 8 Semashko Str., Minsk, Republic of Belarus 220045. ORCID: https://orcid.org/0000-0001-7023-4767. E -mail: olegrumm@tut.by


Table Indications for a patient to be included into liver transplantation waiting list, n (%) 


Fig. 1. Inter-cellular adhesion molecule ICAM-1 in blood serum of liver transplant recipients


Fig. 2. Homocysteinemia parameters in blood serum of liver transplant recipients during waiting and in long-term post-surgery period


Fig. 3. Homocysteinemia dynamics in blood serum of liver transplant recipients during prospective follow-up


Received: 23.03.2020
Accepted: 22.05.2020

22 July 18:05
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