Liver stiffness measurements and short-term survival after left ventricular assist device implantation: A pilot study
| Autor: | Andrea L.C. Schneider, Michael P. Manns, Axel Haverich, Martin Strüber, Jan D. Schmitto, Jerome Schlue, Anika Schettler, Dina Attia, Michael Gebel, Andrej Potthoff, Heiner Wedemeyer, C. Fegbeutel |
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| Rok vydání: | 2014 |
| Předmět: |
Pulmonary and Respiratory Medicine
Liver Cirrhosis Male medicine.medical_specialty Time Factors medicine.medical_treatment Portal venous pressure Pilot Projects Liver disease Internal medicine medicine Humans Prospective Studies Acoustic radiation force impulse imaging Heart Failure Transplantation Univariate analysis medicine.diagnostic_test business.industry Central venous pressure Middle Aged medicine.disease Survival Rate Heart failure Ventricular assist device Cardiology Elasticity Imaging Techniques Surgery Female Radiology Elastography Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 34(12) |
| ISSN: | 1557-3117 |
| Popis: | Hepatic dysfunction can contribute to the clinical outcome of patients with end-stage chronic heart failure (HF). This pilot study evaluated the importance of liver stiffness (LS) measurements by acoustic radiation force impulse (ARFI) imaging elastography in patients with end-stage chronic HF who underwent left ventricular assist device (LVAD) implantation.The study enrolled 28 patients (23 men), mean age of 54 ± 11 years, with end-stage chronic HF selected for LVAD implantation. At baseline, all patients received LS measurements using ARFI elastography. Hepatic venous pressure gradient measurements and transjugular liver biopsies were performed in 16 patients. Liver stiffness was measured 21 days (Follow-up 1, n = 23) and 485 ± 136 days (Follow-up 2, n = 13) after LVAD implantation. Patients were classified according to their baseline LS into Group I (low baseline LS [no significant fibrosis = Metavir F2]) or Group II (high baseline LS [significant fibrosis = Metavir F ≥ 2]).LS at baseline was higher in Group II than in Group I (p0.001) and decreased significantly after LVAD implantation (Follow-up 1, p = 0.002; Follow-up 2, p = 0.002). Baseline LS correlated with liver fibrosis (p = 0.049) and central venous pressure (p = 0.001). Non-survivors showed higher LS (p = 0.019), bilirubin (p = 0.018), Model for End-Stage Liver Disease score (p = 0.001), and liver fibrosis (p = 0.004) compared with the survivors. In the univariate analysis, LS was a significant factor (p = 0.017) in predicting survival after LVAD implantation.ARFI elastography shows that LS is influenced by central venous congestion and histologic changes of the liver in patients with end-stage chronic HF. LS may predict the outcome in patients after LVAD implantation. |
| Databáze: | OpenAIRE |
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