In patients with acute decompensated heart failure with preserved ejection fraction, high liver stiffness measured by 2D-SWE was significantly associated with an increased risk of all-cause mortality and heart failure rehospitalization (HR 3.74).
Observational (n=80)
No
Does increased liver stiffness measured by 2D-SWE predict the composite of all-cause mortality and rehospitalization for worsening HF in patients with acute decompensated HFpEF?
Effect estimate: HR 3.74 (95% CI 1.69-8.62)
p-value: p=0.001
Liver stiffness (LS) assessed by ultrasound elastography reflects right-sided filling pressure and offers additional prognostic information in patients with acute decompensated heart failure (ADHF). However, the prognostic value of LS in heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. This study aimed to investigate the prognostic value of LS measured by two-dimensional shear wave elastography (2D-SWE) in patients with HFpEF.We prospectively enrolled 80 patients hospitalized for decompensated HFpEF between September 2019 and June 2020. Patients were categorized into three groups based on the tertile values of LS at discharge.The third tertile LS group had an older age; more advanced New York Heart Association functional class; higher total bilirubin, γ-glutamyl transferase (GGT), N-terminal pro-B type natriuretic peptide (NT pro-BNP), and Fibrosis-4 index; a larger right ventricle diastolic diameter, higher tricuspid regurgitation pressure gradient, and a larger maximal inferior vena cava diameter. During a median interquartile range follow-up period of 212 (82-275) days, 25 (31.2%) patients suffered composite end points (all-cause mortality and rehospitalization for worsening HF). The third tertile LS group had a significantly higher rate of composite end points (log-rank P = 0.002). A higher LS and the third tertile LS were significantly associated with the composite end points, even after adjusting for a conventional validated HF risk score and other previously reported prognostic risk factors.Increased LS measured by 2D-SWE reflects the severity of liver impairment by liver congestion and fibrosis, underlying right HF, and provides additional information for the prediction of poor outcomes in HFpEF.
Saito et al. (Fri,) conducted a observational in Acute Decompensated Heart Failure with Preserved Ejection Fraction (HFpEF) (n=80). High liver stiffness measured by 2D-SWE (Third tertile ≥10.2 kPa) vs. Lower liver stiffness (First and second tertiles <10.2 kPa) was evaluated on Composite of all-cause mortality and rehospitalization for worsening heart failure (HR 3.74, 95% CI 1.69-8.62, p=0.001). In patients with acute decompensated heart failure with preserved ejection fraction, high liver stiffness measured by 2D-SWE was significantly associated with an increased risk of all-cause mortality and heart failure rehospitalization (HR 3.74).