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


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

J Card Fail. 2019 Feb 02;:

Authors: Soloveva A, Kobalava Z, Fudim M, Ambrosy AP, Villevalde S, Bayarsaikhan M, Garmash I, Naumenko M

Abstract
OBJECTIVE: The significance of liver stiffness (LS) in the setting of cardiovascular congestion during the course of acute decompensated heart failure (ADHF) is under investigation. The aim of this study was to assess LS with transient elastography (TE) and its associations with volume overload by bioimpedance vector analysis (BIVA) in ADHF.
METHODS AND RESULTS: TE (Fibroscan 502 Echosens, France) and BIVA (ABC-01 “Medass”, Russia) were performed in the first 48 hours of admission and on the day of discharge in 149 ADHF patients without known primary chronic liver disease and acute hepatitis. During hospitalization the median value of LS decreased from 12.2 kPa (interquartile range 6.3; 23.6) to 8.7 (5.9; 14.4) kPa (p <0.001). Changes in LS correlated (p <0.001) with changes in weight, BIVA parameters. LS was compared to histologic features of livers of ADHF patients who died (n=7). Liver fibrosis 2B-4 was observed but was not associated with LS. LS at discharge was associated with increased risk of 12-month all-cause death, HF readmission and combined end point.
CONCLUSIONS: There was a moderate association between LS with clinical congestion and volume overload by BIVA and that did not correlate with degree of histologic liver fibrosis. LS may be a marker of negative HF outcomes.

PMID: 30721735 [PubMed – as supplied by publisher]

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