Liver stiffness and prediction of cardiac outcomes in patients with acute decompensated heart failure
| Autor: | Harith Baldawi, Johanna S. van Zyl, Nishah Panchani, Philipp Schulz, Sumeet K. Asrani, Joost Felius, Eun Taek Yoon, Ronald Baxter, Amarinder Bindra |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Heart Failure
Liver Cirrhosis Transplantation Shear wave elastography medicine.medical_specialty Acute decompensated heart failure business.industry medicine.medical_treatment Liver Diseases medicine.disease Liver disease Liver Liver stiffness Ventricular assist device Internal medicine medicine Cardiology Elasticity Imaging Techniques Humans In patient Prospective Studies business Prospective cohort study Hepatic fibrosis |
| Zdroj: | Clinical transplantationREFERENCES. 36(3) |
| ISSN: | 1399-0012 |
| Popis: | Background In acute decompensated heart failure (ADHF), noninvasive markers that predict morbidity and mortality are limited. Liver stiffness measurement (LSM) increases with hepatic fibrosis; however it may be falsely elevated in patients with ADHF in the absence of liver disease. We investigated whether elevated LSM predicts cardiac outcomes in ADHF. Methods In a prospective study, we examined 52 ADHF patients without liver disease between 2016 and 2017. Patients underwent liver 2D shear wave elastography (SWE) and were followed for 12 months to assess the outcomes of left ventricular assist device (LVAD), heart transplant (HT) or death. Results The median LSM was elevated in patients who received an LVAD or HT within 30-days compared to those who did not (median [IQR]: 55.6 [22.5 - 63.4] vs 13.8 [9.5 - 40.3] kPa, p = 0.049). Moreover, the risk of composite outcome was highest in the 3rd tertile (>39.8 kPa compared to 1st and 2nd combined, HR 2.83, 95% CI 1.20- 6.67, p = 0.02). Each 1-kPa increase in LSM was associated with a 1%-increase in the incidence rate of readmissions (IRR 1.01, 95% CI 1.00-1.02, p = 0.01). Conclusions LSM may serve as a novel noninvasive tool to determine LVAD, HT or death in patients with ADHF. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text