|Potential CV Pathophysiology||Diagnostic Findings and Test Operating Characteristics||Recommendations|
|Low HR||Noninvasive stress imaging⁎||CAD|
|Portopulmonary hypertension (pulmonary arterial HTN)||Echocardiography: elevated right-sided and pulmonary pressures. Right-side heart catheterization: mean PAP >25 mm Hg, PVR >3 Wood units in the setting of PCWP <15 mm Hg||Pulmonary heart disease: TTE to assess for pulmonary hypertension, with referral to RHC if elevated PASP or RV systolic dysfunction found on TTE (to differentiate pulmonary venous and pulmonary arterial hypertension) RHC to assess response to medical therapy of confirmed POPH|
|Pericardial effusions||Echocardiography: potentially decreased PPV for tamponade in setting of POPH ± elevated right-sided pressures||Pericardial disease: TTE to assess for pericardial fluid and signs of tamponade|
|Prolonged QTc interval||Electrocardiography: long QTc, potentially reversible sex differences in QTc abolished||Arrhythmia: electrocardiogram to assess baseline QTc interval; treat reversible causes of long QTc|
|Pre-existing intracardiac shunt||Echocardiography: PFO or other intracardiac shunts||Intracardiac shunts: TTE to assess for PFO and other intracardiac shunts; precaution against venous air emboli during transplant procedure|
BP = blood pressure; DM = diabetes mellitus; HF = heart failure; HTN = hypertension; LVH = left ventricular hypertrophy; LVOTO = left ventricular outflow tract obstruction; NPV = negative predictive value; PAP = pulmonary arterial pressure; PASP = pulmonary artery systolic pressure; PCWP = pulmonary capillary wedge pressure; PFO = patent foramen ovale; POPH = portopulmonary hypertension; PVR = pulmonary vascular resistance; QTc = corrected QT interval; RHC = right heart catheterization; RV = right ventricular; SVR = systemic vascular resistance; TTE = transthoracic echocardiography.
↵⁎ Utility of noninvasive testing for coronary artery disease (CAD) detection in liver transplantation candidates (using coronary angiography as the gold standard): positive/negative predictive values for dobutamine stress echocardiography (DSE) = 22%/75%, respectively (Harinstein et al. ), 33%/100% (Donovan et al. ), 0%/86% (Williams et al. ). Positive/negative predictive values for single-photon emission computed tomography (SPECT) = 22%/77%, respectively (Davidson et al. ), 15%/100% (Aydinalp et al. ).
↵† Traditional risk factors for CAD include age (male >45 years/female >55 years), hypercholesterolemia, hypertension, tobacco use, and family history of early CAD (first-degree relative male <55 years/female <65 years).