TY - JOUR
T1 - Impact of heart failure and changes to volume status on liver stiffness: non-invasive assessment using transient elastography
AU - Hopper, Ingrid
AU - Kemp, William
AU - Porapakkham, Pornwalee
AU - Sata, Yusuke
AU - Condon, Eilis
AU - Skiba, Marina
AU - Forber, Lauren
AU - Porapakkham, Pramote
AU - Williams, Trevor
AU - Menahem, Solomon
AU - Roberts, Stuart
AU - Krum, Henry
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
UR - http://eurjhf.oxfordjournals.org/content/14/6/621.full.pdf
U2 - 10.1093/eurjhf/hfs044
DO - 10.1093/eurjhf/hfs044
M3 - Article
SN - 1388-9842
VL - 14
SP - 621
EP - 627
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 6
ER -