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Impact of heart failure and changes to volume status on liver stiffness: non‐invasive assessment using transient elastography
Author(s) -
Hopper Ingrid,
Kemp William,
Porapakkham Pornwalee,
Sata Yusuke,
Condon Eilis,
Skiba Marina,
Farber Lauren,
Porapakkham Pramote,
Williams Trevor J.,
Menahem Solomon,
Roberts Stuart,
Krum Henry
Publication year - 2012
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfs044
Subject(s) - medicine , heart failure , acute decompensated heart failure , cardiology , transient elastography , cirrhosis , intravascular volume status , diuresis , percentile , renal function , hemodynamics , liver fibrosis , statistics , mathematics
Aim The impact of cardiac dysfunction on the liver is known as cardiac hepatopathy. In certain instances this can result in significant hepatic fibrosis or cirrhosis. The validity of non‐invasive tools to assess hepatic fibrosis, such as FibroScan ® which measures liver stiffness (LSM), has not been established in this setting. We examined the impact of cardiac dysfunction on LSM using FibroScan ® and the influence of volume changes on LSM. Methods and results A prospective, cross‐sectional study examined the use of FibroScan ® in subjects with left‐sided heart failure (LHF, n = 32), right‐sided heart failure (RHF, n = 9), and acute decompensated heart failure (ADHF, n = 8). The impact of volume changes upon LSM was further examined in the ADHF group (pre‐ and post‐diuresis) and in a haemodialysis group (HD, n = 12), pre‐ and post‐ultrafiltration on dialysis. Compared with healthy controls [ n = 55, LSM = median 4.4 (25th percentile 3.6, 75th percentile 5.1) kPa], LSM was increased in all the cardiac dysfunction subgroups [LHF, 4.7 (4.0, 8.7) kPa, P = 0.04; RHF, 9.7 (5.0, 10.8) kPa, P < 0.001; ADHF, 11.2 (6.7, 14.3) kPa, P < 0.001]. Alteration in volume status via diuresis did not change the baseline LSM in ADHF [11.2 (6.7, 14.3) to 9.5 (7.3, 21.6) kPa, P > 0.05] with mean diuresis 5051 ± 1585 mL, or ultrafiltration in HD [6.0 (3.6, 5.1) vs. 5.7 (4.8, 7.0) kPa, P > 0.05] with mean diuresis 1962 ± 233 mL. Conclusion Our findings support the concept of increased LSM in the cardiac failure population. LSM was not altered to a statistically significant level with acute volume changes.