Liver stiffness and prediction of cardiac outcomes in patients with acute decompensated heart failure

2021 ◽  
Author(s):  
Nishah Panchani ◽  
Philipp Schulz ◽  
Johanna Van Zyl ◽  
Joost Felius ◽  
Ronald Baxter ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Liver Stiffness ◽  
Decompensated Heart Failure ◽  
Cardiac Outcomes

CLINICAL SIGNIFICANCE OF LIVER STIFFNESS ASSESSED BY TRANSIENT ELASTOGRAPHY IN ACUTE DECOMPENSATED HEART FAILURE

2018 ◽  
Vol 71 (11) ◽  
pp. A975
Author(s):  
Yuki Saito ◽  
Mahoto Kato ◽  
Koichi Nagashima ◽  
Koyuru Monno ◽  
Yoshihiro Aizawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Significance ◽  
Transient Elastography ◽  
Acute Decompensated Heart Failure ◽  
Liver Stiffness ◽  
Decompensated Heart Failure

Impact of admission liver stiffness on long-term clinical outcomes in patients with acute decompensated heart failure

2018 ◽  
Vol 34 (6) ◽  
pp. 984-991 ◽  
Author(s):  
Kazunori Omote ◽  
Toshiyuki Nagai ◽  
Naoya Asakawa ◽  
Kiwamu Kamiya ◽  
Yusuke Tokuda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Acute Decompensated Heart Failure ◽  
Liver Stiffness ◽  
Decompensated Heart Failure

P787Long-term prognostic value of the combination of fibrosis-4 index and acute kidney injury in patients with admitted for acute decompensated heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Yamada ◽  
T Morita ◽  
Y Furukawa ◽  
S Tamaki ◽  
M Kawasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Acute Decompensated Heart Failure ◽  
Prognostic Significance ◽  
Liver Stiffness ◽  
Total Mortality ◽  
Kidney Injury ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Nitrogen Levels

Abstract Background Liver dysfunction in patients with heart failure (HF) is caused by liver congestion, which is related to liver stiffness. It was reported that liver stiffness assessed by non-invasive fibrosis marker such as Fibrosis-4 (FIB4) index (based on age, aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels, and platelet counts) predicts mortality in HF pts. Acute kidney injury (AKI) during HF treatment is associated with poor outcome in pts admitted for acute decompensated heart failure (ADHF). However, there is no information available on the long-term prognostic significance of the combination of FIB4 index and AKI in ADHF pts. Methods and results We studied 299 ADHF pts with survival discharge. FIB4 index was calculated by the formula: age (yrs) × AST[U/L]/(platelets [103/μL] × (ALT[U/L])1/2). AKI during ADHF treatment was defined according to AKI Network criteria (stage 1: mild, stage 2: moderate, stage 3: severe). During a follow-up period of 4.3±3.3 yrs, 94 pts died. At multivariate Cox analysis, FIB4 index and stage2/3 AKI, but not stage1 AKI, significantly associated with total mortality, independently of prior HF hospitalization and serum sodium and blood urea nitrogen levels after adjustment with BMI, systolic blood pressure, hemoglobin, serum creatinine and albumin levels, left ventricular end-diastolic and left atrial dimension indexes. Pts with both greater FIB4 index (>2.674: median) and stage 2/3 AKI had a significantly higher risk of total mortality than those with none of them. Adjusted hazard ratio in pts with both greater FIB4 index and stage 2/3 AKI was 3.5 (95% CI 1.6–7.7), which was two-fold of that in pts with either of them (1.7 [95% CI 1.1–2.7]). Conclusion The combination of FIB4 index and moderate to severe AKI might identify higher risk subset for total mortality in ADHF pts.

Abstract 12989: Long-term Prognostic Value of Fibrosis-4 Index and Albumin-bilirubin Score in Patients Admitted for Acute Decompensated Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takahisa Yamada ◽  
Tetsuya Watanabe ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Shunsuke Tamaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Liver Stiffness ◽  
Total Mortality ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Prognostic Information ◽  
Fibrosis Marker ◽  
Cox Analysis

Backgrounds: Cardiohepatic interactions have been a focus of attention among heart failure (HF). It was reported that liver stiffness assessed by non-invasive fibrosis marker such as Fibrosis-4(FIB4) index provide prognostic information in HF patients. Furthermore, the albumin-bilirubin (ALBI) score has recently been proposed as a validated index of liver dysfunction. We sought to investigate the long-term prognostic values of the combination of FIB4 index and ALBI score in patients admitted for acute decompensated heart failure (ADHF). Methods and Results: We studied 299 ADHF pts with survival discharge. FIB4 index was calculated by the formula: age(yrs) х AST[U/L]/(platelets [10 3 /μL] х (ALT[U/L]) 1/2 ). The ALBI was calculated using the formula: log 10 (total bilirubin) х 0.66 + albuminх-0.085. During a follow-up period of 4.3±3.3 yrs, 94 patients died. At multivariate Cox analysis, FIB4 index and ALBI score were significantly associated with total mortality, independently of prior HF hospitalization and body mass index after adjustment with systolic blood pressure, left ventricular end-diastolic dimension and left atrial dimension indexes. Patients with both greater FIB4 index (>3.608: top tertile) and ALBI score (>-2.076:top tertile) had a significantly higher risk of total mortality than those with either or none of them (46% vs 34% vs 25%, respectively, p=0.002). Conclusion: The combination of FIB4 index and ALBI score might identify higher risk subset for total mortality in ADHF patients.

Relationship of Liver Stiffness With Congestion in Patients Presenting With Acute Decompensated Heart Failure

2019 ◽  
Vol 25 (3) ◽  
pp. 176-187 ◽  
Author(s):  
Anzhela Soloveva ◽  
Zhanna Kobalava ◽  
Marat Fudim ◽  
Andrew P. Ambrosy ◽  
Svetlana Villevalde ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Liver Stiffness ◽  
Decompensated Heart Failure ◽  
Relationship Of

Prognostic value of pulmonary-systemic pressure ratio and fibrosis-4 index in patients admitted for acute decompensated heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
Y Furukawa ◽  
S Tamaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Acute Decompensated Heart Failure ◽  
Pressure Ratio ◽  
Liver Stiffness ◽  
Total Mortality ◽  
Decompensated Heart Failure ◽  
Systemic Arterial Pressure ◽  
Heart Catheterization ◽  
Increased Risk

Abstract Background Concomitant presence of pulmonary hypertension in heart failure (HF) is associated with increased adverse events and may be related to interventricular uncoupling and impaired cardiac efficiency. An increased mean pulmonary artery pressure to mean systemic arterial pressure ratio (MPS ratio), a marker of interventricular coupling and efficiency, is reported to be associated with worse clinical outcomes in patients with advanced HF. On the other hand, cardiohepatic interactions have been a focus of attention in HF, and liver dysfunction in HF patients is caused by liver congestion, which is related to liver stiffness. It has been recently shown that liver stiffness assessed by non-invasive fibrosis marker such as Fibrosis-4 (FIB4) index predicts the mortality in HF patients. However, there is no information available on the prognostic value of the combination of MPS ratio and FIB4 index in patients with acute decompensated heart failure (ADHF). Methods and results We studied 238 patients admitted for ADHF, who underwent right heart catheterization at the admission and were discharged with survival. MPS ratio was obtained at the admission. FIB4 index was calculated by the formula: age (yrs) × AST [U/L] / (platelets [103/μL] × √(ALT[U/L])). FIB4 index >2.67 was defined as abnormal, as previously reported. During a follow up period of 5.2±4.4 yrs, 93 patients died. At multivariate Cox analysis, MPS ratio (p=0.01) and FIB4 index (p=0.01) were significantly associated with the total mortality, independently of creatinine level and prior heart failure hospitalization, after the adjustment with hemoglobin, albumin levels and body mass index. The patients with both MPS ratio ≥0.388 (determined by ROC analysis; AUC 0.613 [0.541–0.687]) and abnormal FIB4 index had a significantly increased risk of the total mortality than those with either greater MPS or abnormal FIB4 index and none of them (52% vs 40% vs 28%, p=0.0068, respectively). Conclusion The combination of MPS ratio and FIB4 index might be useful for stratifying ADHF patients at higher risk for the total mortality. Funding Acknowledgement Type of funding source: None

scholarly journals Prognostic Relevance of Liver Stiffness Assessed by Transient Elastography in Patients With Acute Decompensated Heart Failure

2018 ◽  
Vol 82 (7) ◽  
pp. 1822-1829 ◽  
Author(s):  
Yuki Saito ◽  
Mahoto Kato ◽  
Koichi Nagashima ◽  
Koyuru Monno ◽  
Yoshihiro Aizawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Transient Elastography ◽  
Acute Decompensated Heart Failure ◽  
Liver Stiffness ◽  
Decompensated Heart Failure ◽  
Prognostic Relevance
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