December 9, 2014Circulation JournalOpen Access

Novel Method of Evaluating Liver Stiffness Using Transient Elastography to Evaluate Perioperative Status in Severe Heart Failure

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Severe heart failure (n=30). Intervention: Preoperative liver stiffness >12.5 kPa vs. Preoperative liver stiffness ≤12.5 kPa. Primary outcome: Major adverse events (MAE) within 30 days (p=<0.05).

View Full Paper

Ask AI

Bookmark

Key result

Preoperative liver stiffness >12.5 kPa was associated with an 80% incidence of major adverse events compared to 25% in patients with ≤12.5 kPa following LVAD implantation.

Why the study?

Does liver stiffness measured by transient elastography predict the requirement of RVAD and major adverse events in patients with severe heart failure undergoing LVAD implantation?

Population

30 patients with severe heart failure who underwent left ventricular assist device implantation. Exclusion…

Design

Cohort

Follow-up

30 days

Authors

HNHiroyuki Nishi KTKöichi Toda SMShigeru Miyagawa

Discussion

Member takes

Overview

May support preoperative risk stratification before LVAD; leaves open whether elastography should guide RVAD decisions.

Study Design

Type

Observational (n=30)

Multicenter

Structured PICO

Does liver stiffness measured by transient elastography predict the requirement of RVAD and major adverse events in patients with severe heart failure undergoing LVAD implantation?

Population

30 patients with severe heart failure undergoing left ventricular assist device implantation, free of primary liver disease, evaluated for perioperative liver stiffness and followed for 30 days.

Exposure

Measurement of liver stiffness (LS) using transient elastography (FibroScan) pre- and postoperatively.

Outcome

Requirement of additional right heart support (right ventricular assist device [RVAD]) and major adverse events (MAE) defined as mortality, postoperative bleeding, cerebrovascular event, and infection within 30 days postoperatively.composite

Main Result

Absolute Event Rate: 80% vs 25%

p-value: p=<0.05

Liver stiffness measured by transient elastography is a useful non-invasive marker that correlates with preoperative severity and predicts the need for right ventricular assist device support and postoperative complications in patients undergoing LVAD implantation.

Limitations

No liver biopsy results were available to correlate liver stiffness with underlying histological severity of liver fibrosis.
The critically ill nature of the cohort limits interpretation and generalizability to general heart failure patients.
Liver stiffness is influenced by specific conditions such as hepatitis, inflammation, and cholestasis.
Small sample size.
No liver biopsy to correlate liver stiffness with histologic findings
Critically ill cohort limits generalizability to general heart failure patients
Liver stiffness is influenced by specific conditions such as hepatitis, inflammation, and cholestasis
Small sample size

Cite This Study

Nishi et al. (2014) conducted an observational in Severe heart failure (n=30). Preoperative liver stiffness >12.5 kPa vs. Preoperative liver stiffness ≤12.5 kPa was evaluated on Major adverse events (MAE) within 30 days (p=<0.05). Preoperative liver stiffness >12.5 kPa was associated with an 80% incidence of major adverse events compared to 25% in patients with ≤12.5 kPa following LVAD implantation.

synapsesocial.com/papers/6a882e8ff9cabcdfeb4a6719 https://doi.org/10.1253/circj.cj-14-0929

View Full Paper

Ask AI

Bookmark

December 9, 2014Circulation JournalOpen Access

Novel Method of Evaluating Liver Stiffness Using Transient Elastography to Evaluate Perioperative Status in Severe Heart Failure

View Full Paper

Ask AI

Bookmark

Key result

Preoperative liver stiffness >12.5 kPa was associated with an 80% incidence of major adverse events compared to 25% in patients with ≤12.5 kPa following LVAD implantation.

Why the study?

Does liver stiffness measured by transient elastography predict the requirement of RVAD and major adverse events in patients with severe heart failure undergoing LVAD implantation?

Population

30 patients with severe heart failure who underwent left ventricular assist device implantation. Exclusion…

Design

Cohort

Follow-up

30 days

Authors

HNHiroyuki Nishi KTKöichi Toda SMShigeru Miyagawa

Discussion

Member takes

Overview

May support preoperative risk stratification before LVAD; leaves open whether elastography should guide RVAD decisions.

Study Design

Type

Observational (n=30)

Multicenter

Structured PICO

Does liver stiffness measured by transient elastography predict the requirement of RVAD and major adverse events in patients with severe heart failure undergoing LVAD implantation?

Population

30 patients with severe heart failure undergoing left ventricular assist device implantation, free of primary liver disease, evaluated for perioperative liver stiffness and followed for 30 days.

Exposure

Measurement of liver stiffness (LS) using transient elastography (FibroScan) pre- and postoperatively.

Outcome

Main Result

Absolute Event Rate: 80% vs 25%

p-value: p=<0.05

Limitations

No liver biopsy results were available to correlate liver stiffness with underlying histological severity of liver fibrosis.
The critically ill nature of the cohort limits interpretation and generalizability to general heart failure patients.
Liver stiffness is influenced by specific conditions such as hepatitis, inflammation, and cholestasis.
Small sample size.
No liver biopsy to correlate liver stiffness with histologic findings
Critically ill cohort limits generalizability to general heart failure patients
Liver stiffness is influenced by specific conditions such as hepatitis, inflammation, and cholestasis
Small sample size

Cite This Study

synapsesocial.com/papers/6a882e8ff9cabcdfeb4a6719 https://doi.org/10.1253/circj.cj-14-0929

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

View Full Paper

Ask AI

Bookmark