Aortic Valve and Mitral Annular Calcification in Cirrhotic Patients and Potential Liver Transplant Recipients - A Single-Center Observational Study

Background/Objectives: Liver cirrhosis (LC), irrespective of its etiology, is associated with increased mortality from cardiovascular causes. In this study, we aimed to reveal the relationship between fatty LC (nonalcoholic and alcohol related liver diseases) and other causes of LC with aortic valve and mitral annular calcifica-tion. Methods: One hundred and twenty-three LC patients and an equal number of age- and sex-matched cardiovascular patients without cirrhosis or indications for heart valve surgery were included in the study. The two groups were compared in terms of demographic, clinical, and echocardiographic characteristics. In total, 70 fe-male and 176 male patients, with a median age of 64.0 years (range, 58.0-70.0 years), were included in the analysis. Results: Binary logistic regression analyses revealed a significant association between fatty LC and aortic valve calcification, whereas LC, regardless of its cause, was associated with mitral annular calcification. Previous car-diac surgery due to atherosclerosis-related ischemic heart disease and mitral annular calcification were also associated with aortic valve calcification. In contrast, BMI, aor-tic valve calcification, aortic root calcification, and mitral valve calcification were re-lated to the occurrence of mitral annular calcification. The findings also revealed a stark contrast in the burden of atherosclerotic cardiovascular disease risk factors be-tween the two groups. Conclusions: The incidence of heart valve calcification should be considered in the management of cirrhosis patients as potential liver transplant re-cipients for more comprehensive preoperative risk stratification and postoperative follow-ups to identify patients that may benefit from either percutaneous or surgical valvular therapy.