Skip to main content
Erschienen in: Heart and Vessels 6/2019

06.12.2018 | Original Article

Impact of admission liver stiffness on long-term clinical outcomes in patients with acute decompensated heart failure

verfasst von: Kazunori Omote, Toshiyuki Nagai, Naoya Asakawa, Kiwamu Kamiya, Yusuke Tokuda, Tadao Aikawa, Arata Fukushima, Keiji Noguchi, Yoshiya Kato, Hirokazu Komoriyama, Mutsumi Nishida, Yusuke Kudo, Hiroyuki Iwano, Takashi Yokota, Toshihisa Anzai

Erschienen in: Heart and Vessels | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Liver stiffness (LS) has been reported to be a marker of liver congestion caused by elevated central venous pressure in heart failure (HF) patients. Recent studies demonstrated that LS could be non-invasively measured by virtual touch quantification (VTQ). However, its prognostic implication in patients with acute decompensated heart failure (ADHF) is unclear. This study sought to determine whether LS measured by VTQ could be a determinant of subsequent adverse events in ADHF patients. We prospectively recruited 70 ADHF patients who underwent LS measurement by VTQ on admission in our university hospital between June 2016 and April 2018. The primary outcome of interest was the composite of all-cause mortality and worsening HF. During a median follow-up period of 272 (interquartile range 122–578) days, there were 26 (37%) events, including 5 (7%) deaths and 21 (30%) cases of worsening HF. The c-index of LS for predicting the composite of adverse events was 0.77 (95% CI 0.66–0.88), and the optimal cut-off value of LS was 1.50 m/s. Adverse events were more frequently observed in patients with high LS (≥ 1.50 m/s) compared to those with low LS (< 1.50 m/s). Multivariable Cox regression analyzes revealed that higher LS was independently associated with increased subsequent risk of adverse events after adjustment for confounders. In conclusion, high admission LS was an independent determinant of worse clinical outcomes in patients with ADHF. This finding suggests that LS on admission is useful for risk stratification of patients with ADHF.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
2.
Zurück zum Zitat Damman K, van Deursen VM, Navis G, Voors AA, van Veldhuisen DJ, Hillege HL (2009) Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J Am Coll Cardiol 53:582–588CrossRefPubMed Damman K, van Deursen VM, Navis G, Voors AA, van Veldhuisen DJ, Hillege HL (2009) Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J Am Coll Cardiol 53:582–588CrossRefPubMed
3.
Zurück zum Zitat Mullens W, Abrahams Z, Francis GS, Sokos G, Taylor DO, Starling RC, Young JB, Tang WH (2009) Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol 53:589–596CrossRefPubMedPubMedCentral Mullens W, Abrahams Z, Francis GS, Sokos G, Taylor DO, Starling RC, Young JB, Tang WH (2009) Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol 53:589–596CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, Rigaud JP, Casciani D, Misset B, Bosquet C, Outin H, Brun-Buisson C, Nitenberg G (2001) Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 286:700–707CrossRefPubMed Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, Rigaud JP, Casciani D, Misset B, Bosquet C, Outin H, Brun-Buisson C, Nitenberg G (2001) Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 286:700–707CrossRefPubMed
5.
Zurück zum Zitat Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM (1994) Complications and failures of subclavian-vein catheterization. N Engl J Med 331:1735–1738CrossRefPubMed Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM (1994) Complications and failures of subclavian-vein catheterization. N Engl J Med 331:1735–1738CrossRefPubMed
6.
Zurück zum Zitat Hopper I, Kemp W, Porapakkham P, Sata Y, Condon E, Skiba M, Farber L, Porapakkham P, Williams TJ, Menahem S, Roberts S, Krum H (2012) Impact of heart failure and changes to volume status on liver stiffness: non-invasive assessment using transient elastography. Eur J Heart Fail 14:621–627CrossRefPubMed Hopper I, Kemp W, Porapakkham P, Sata Y, Condon E, Skiba M, Farber L, Porapakkham P, Williams TJ, Menahem S, Roberts S, Krum H (2012) Impact of heart failure and changes to volume status on liver stiffness: non-invasive assessment using transient elastography. Eur J Heart Fail 14:621–627CrossRefPubMed
7.
Zurück zum Zitat Potthoff A, Schettler A, Attia D, Schlue J, Schmitto JD, Fegbeutel C, Struber M, Haverich A, Manns MP, Wedemeyer H, Gebel M, Schneider A (2015) Liver stiffness measurements and short-term survival after left ventricular assist device implantation: a pilot study. J Heart Lung Transplant 34:1586–1594CrossRefPubMed Potthoff A, Schettler A, Attia D, Schlue J, Schmitto JD, Fegbeutel C, Struber M, Haverich A, Manns MP, Wedemeyer H, Gebel M, Schneider A (2015) Liver stiffness measurements and short-term survival after left ventricular assist device implantation: a pilot study. J Heart Lung Transplant 34:1586–1594CrossRefPubMed
8.
Zurück zum Zitat Taniguchi T, Sakata Y, Ohtani T, Mizote I, Takeda Y, Asano Y, Masuda M, Minamiguchi H, Kanzaki M, Ichibori Y, Nishi H, Toda K, Sawa Y, Komuro I (2014) Usefulness of transient elastography for noninvasive and reliable estimation of right-sided filling pressure in heart failure. Am J Cardiol 113:552–558CrossRefPubMed Taniguchi T, Sakata Y, Ohtani T, Mizote I, Takeda Y, Asano Y, Masuda M, Minamiguchi H, Kanzaki M, Ichibori Y, Nishi H, Toda K, Sawa Y, Komuro I (2014) Usefulness of transient elastography for noninvasive and reliable estimation of right-sided filling pressure in heart failure. Am J Cardiol 113:552–558CrossRefPubMed
9.
Zurück zum Zitat Yoshitani T, Asakawa N, Sakakibara M, Noguchi K, Tokuda Y, Kamiya K, Iwano H, Yamada S, Kudou Y, Nishida M, Shimizu C, Amano T, Tsutsui H (2016) Value of virtual touch quantification elastography for assessing liver congestion in patients with heart failure. Circ J 80:1187–1195CrossRefPubMed Yoshitani T, Asakawa N, Sakakibara M, Noguchi K, Tokuda Y, Kamiya K, Iwano H, Yamada S, Kudou Y, Nishida M, Shimizu C, Amano T, Tsutsui H (2016) Value of virtual touch quantification elastography for assessing liver congestion in patients with heart failure. Circ J 80:1187–1195CrossRefPubMed
11.
Zurück zum Zitat McKee PA, Castelli WP, McNamara PM, Kannel WB (1971) The natural history of congestive heart failure: the Framingham study. N Engl J Med 285:1441–1446CrossRefPubMed McKee PA, Castelli WP, McNamara PM, Kannel WB (1971) The natural history of congestive heart failure: the Framingham study. N Engl J Med 285:1441–1446CrossRefPubMed
12.
Zurück zum Zitat Schiller NB, Acquatella H, Ports TA, Drew D, Goerke J, Ringertz H, Silverman NH, Brundage B, Botvinick EH, Boswell R, Carlsson E, Parmley WW (1979) Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 60:547–555CrossRefPubMed Schiller NB, Acquatella H, Ports TA, Drew D, Goerke J, Ringertz H, Silverman NH, Brundage B, Botvinick EH, Boswell R, Carlsson E, Parmley WW (1979) Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 60:547–555CrossRefPubMed
13.
Zurück zum Zitat Massie BM, O'Connor CM, Metra M, Ponikowski P, Teerlink JR, Cotter G, Weatherley BD, Cleland JG, Givertz MM, Voors A, DeLucca P, Mansoor GA, Salerno CM, Bloomfield DM, Dittrich HC, Committees PIa (2010) Rolofylline, an adenosine A1-receptor antagonist, in acute heart failure. N Engl J Med 363(15):1419–1428CrossRefPubMed Massie BM, O'Connor CM, Metra M, Ponikowski P, Teerlink JR, Cotter G, Weatherley BD, Cleland JG, Givertz MM, Voors A, DeLucca P, Mansoor GA, Salerno CM, Bloomfield DM, Dittrich HC, Committees PIa (2010) Rolofylline, an adenosine A1-receptor antagonist, in acute heart failure. N Engl J Med 363(15):1419–1428CrossRefPubMed
14.
Zurück zum Zitat Teerlink JR, Cotter G, Davison BA, Felker GM, Filippatos G, Greenberg BH, Ponikowski P, Unemori E, Voors AA, Adams KF Jr, Dorobantu MI, Grinfeld LR, Jondeau G, Marmor A, Masip J, Pang PS, Werdan K, Teichman SL, Trapani A, Bush CA, Saini R, Schumacher C, Severin TM, Metra M, RiAHFR-A Investigators (2013) Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial. Lancet 381(9860):29–39CrossRefPubMed Teerlink JR, Cotter G, Davison BA, Felker GM, Filippatos G, Greenberg BH, Ponikowski P, Unemori E, Voors AA, Adams KF Jr, Dorobantu MI, Grinfeld LR, Jondeau G, Marmor A, Masip J, Pang PS, Werdan K, Teichman SL, Trapani A, Bush CA, Saini R, Schumacher C, Severin TM, Metra M, RiAHFR-A Investigators (2013) Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial. Lancet 381(9860):29–39CrossRefPubMed
15.
Zurück zum Zitat Dzau VJ, Colucci WS, Hollenberg NK, Williams GH (1981) Relation of the renin–angiotensin-aldosterone system to clinical state in congestive heart failure. Circulation 63:645–651CrossRefPubMed Dzau VJ, Colucci WS, Hollenberg NK, Williams GH (1981) Relation of the renin–angiotensin-aldosterone system to clinical state in congestive heart failure. Circulation 63:645–651CrossRefPubMed
16.
Zurück zum Zitat Stewart JM, Zeballos GA, Woolf PK, Dweck HS, Gewitz MH (1988) Variable arginine vasopressin levels in neonatal congestive heart failure. J Am Coll Cardiol 11:645–650CrossRefPubMed Stewart JM, Zeballos GA, Woolf PK, Dweck HS, Gewitz MH (1988) Variable arginine vasopressin levels in neonatal congestive heart failure. J Am Coll Cardiol 11:645–650CrossRefPubMed
17.
Zurück zum Zitat Damman K, Navis G, Smilde TD, Voors AA, van der Bij W, van Veldhuisen DJ, Hillege HL (2007) Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction. Eur J Heart Fail 9:872–878CrossRefPubMed Damman K, Navis G, Smilde TD, Voors AA, van der Bij W, van Veldhuisen DJ, Hillege HL (2007) Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction. Eur J Heart Fail 9:872–878CrossRefPubMed
18.
Zurück zum Zitat Uthoff H, Thalhammer C, Potocki M, Reichlin T, Noveanu M, Aschwanden M, Staub D, Arenja N, Socrates T, Twerenbold R, Mutschmann-Sanchez S, Heinisch C, Jaeger KA, Mebazaa A, Mueller C (2010) Central venous pressure at emergency room presentation predicts cardiac rehospitalization in patients with decompensated heart failure. Eur J Heart Fail 12:469–476CrossRefPubMed Uthoff H, Thalhammer C, Potocki M, Reichlin T, Noveanu M, Aschwanden M, Staub D, Arenja N, Socrates T, Twerenbold R, Mutschmann-Sanchez S, Heinisch C, Jaeger KA, Mebazaa A, Mueller C (2010) Central venous pressure at emergency room presentation predicts cardiac rehospitalization in patients with decompensated heart failure. Eur J Heart Fail 12:469–476CrossRefPubMed
19.
Zurück zum Zitat Adamson PB, Magalski A, Braunschweig F, Bohm M, Reynolds D, Steinhaus D, Luby A, Linde C, Ryden L, Cremers B, Takle T, Bennett T (2003) Ongoing right ventricular hemodynamics in heart failure: clinical value of measurements derived from an implantable monitoring system. J Am Coll Cardiol 41:565–571CrossRefPubMed Adamson PB, Magalski A, Braunschweig F, Bohm M, Reynolds D, Steinhaus D, Luby A, Linde C, Ryden L, Cremers B, Takle T, Bennett T (2003) Ongoing right ventricular hemodynamics in heart failure: clinical value of measurements derived from an implantable monitoring system. J Am Coll Cardiol 41:565–571CrossRefPubMed
20.
Zurück zum Zitat Damman K, Valente MA, Voors AA, O'Connor CM, van Veldhuisen DJ, Hillege HL (2014) Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis. Eur Heart J 35:455–469CrossRefPubMed Damman K, Valente MA, Voors AA, O'Connor CM, van Veldhuisen DJ, Hillege HL (2014) Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis. Eur Heart J 35:455–469CrossRefPubMed
21.
Zurück zum Zitat Maeder MT, Rickli H, Pfisterer ME, Muzzarelli S, Ammann P, Fehr T, Hack D, Weilenmann D, Dieterle T, Kiencke S, Estlinbaum W, Brunner-La Rocca HP (2012) Incidence, clinical predictors, and prognostic impact of worsening renal function in elderly patients with chronic heart failure on intensive medical therapy. Am Heart J 163(407–414):414.e1 Maeder MT, Rickli H, Pfisterer ME, Muzzarelli S, Ammann P, Fehr T, Hack D, Weilenmann D, Dieterle T, Kiencke S, Estlinbaum W, Brunner-La Rocca HP (2012) Incidence, clinical predictors, and prognostic impact of worsening renal function in elderly patients with chronic heart failure on intensive medical therapy. Am Heart J 163(407–414):414.e1
22.
Zurück zum Zitat Murata A, Kasai T, Matsue Y, Matsumoto H, Yatsu S, Kato T, Suda S, Hiki M, Takagi A, Daida H (2018) Relationship between blood urea nitrogen-to-creatinine ratio at hospital admission and long-term mortality in patients with acute decompensated heart failure. Heart Vessels 33:877–885CrossRefPubMed Murata A, Kasai T, Matsue Y, Matsumoto H, Yatsu S, Kato T, Suda S, Hiki M, Takagi A, Daida H (2018) Relationship between blood urea nitrogen-to-creatinine ratio at hospital admission and long-term mortality in patients with acute decompensated heart failure. Heart Vessels 33:877–885CrossRefPubMed
23.
Zurück zum Zitat Takaya Y, Yoshihara F, Yokoyama H, Kanzaki H, Kitakaze M, Goto Y, Anzai T, Yasuda S, Ogawa H, Kawano Y, Kangawa K (2017) Impact of decreased serum albumin levels on acute kidney injury in patients with acute decompensated heart failure: a potential association of atrial natriuretic peptide. Heart Vessels 32:932–943CrossRefPubMed Takaya Y, Yoshihara F, Yokoyama H, Kanzaki H, Kitakaze M, Goto Y, Anzai T, Yasuda S, Ogawa H, Kawano Y, Kangawa K (2017) Impact of decreased serum albumin levels on acute kidney injury in patients with acute decompensated heart failure: a potential association of atrial natriuretic peptide. Heart Vessels 32:932–943CrossRefPubMed
24.
Zurück zum Zitat Jalal Z, Iriart X, De Ledinghen V, Barnetche T, Hiriart JB, Vergniol J, Foucher J, Thambo JB (2015) Liver stiffness measurements for evaluation of central venous pressure in congenital heart diseases. Heart 101:1499–1504CrossRefPubMed Jalal Z, Iriart X, De Ledinghen V, Barnetche T, Hiriart JB, Vergniol J, Foucher J, Thambo JB (2015) Liver stiffness measurements for evaluation of central venous pressure in congenital heart diseases. Heart 101:1499–1504CrossRefPubMed
25.
Zurück zum Zitat Kashiyama N, Toda K, Nakamura T, Miyagawa S, Nishi H, Yoshikawa Y, Fukushima S, Saito S, Yoshioka D, Sawa Y (2017) Evaluation of right ventricular function using liver stiffness in patients with left ventricular assist device. Eur J Cardiothorac Surg 51:715–721CrossRefPubMedPubMedCentral Kashiyama N, Toda K, Nakamura T, Miyagawa S, Nishi H, Yoshikawa Y, Fukushima S, Saito S, Yoshioka D, Sawa Y (2017) Evaluation of right ventricular function using liver stiffness in patients with left ventricular assist device. Eur J Cardiothorac Surg 51:715–721CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Millonig G, Friedrich S, Adolf S, Fonouni H, Golriz M, Mehrabi A, Stiefel P, Poschl G, Buchler MW, Seitz HK, Mueller S (2010) Liver stiffness is directly influenced by central venous pressure. J Hepatol 52:206–210CrossRefPubMed Millonig G, Friedrich S, Adolf S, Fonouni H, Golriz M, Mehrabi A, Stiefel P, Poschl G, Buchler MW, Seitz HK, Mueller S (2010) Liver stiffness is directly influenced by central venous pressure. J Hepatol 52:206–210CrossRefPubMed
27.
Zurück zum Zitat Nishi H, Toda K, Miyagawa S, Yoshikawa Y, Fukushima S, Kawamura M, Saito T, Yoshioka D, Daimon T, Sawa Y (2015) Novel method of evaluating liver stiffness using transient elastography to evaluate perioperative status in severe heart failure. Circ J 79:391–397CrossRefPubMed Nishi H, Toda K, Miyagawa S, Yoshikawa Y, Fukushima S, Kawamura M, Saito T, Yoshioka D, Daimon T, Sawa Y (2015) Novel method of evaluating liver stiffness using transient elastography to evaluate perioperative status in severe heart failure. Circ J 79:391–397CrossRefPubMed
28.
Zurück zum Zitat Colli A, Pozzoni P, Berzuini A, Gerosa A, Canovi C, Molteni EE, Barbarini M, Bonino F, Prati D (2010) Decompensated chronic heart failure: increased liver stiffness measured by means of transient elastography. Radiology 257:872–878CrossRefPubMed Colli A, Pozzoni P, Berzuini A, Gerosa A, Canovi C, Molteni EE, Barbarini M, Bonino F, Prati D (2010) Decompensated chronic heart failure: increased liver stiffness measured by means of transient elastography. Radiology 257:872–878CrossRefPubMed
29.
Zurück zum Zitat Castera L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, Couzigou P, de Ledinghen V (2010) Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology 51:828–835PubMed Castera L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, Couzigou P, de Ledinghen V (2010) Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology 51:828–835PubMed
30.
Zurück zum Zitat Lynch M, Higgins E, McCormick PA, Kirby B, Nolan N, Rogers S, Lally A, Vellinga A, Omar H, Collins P (2014) The use of transient elastography and FibroTest for monitoring hepatotoxicity in patients receiving methotrexate for psoriasis. JAMA Dermatol 150:856–862CrossRefPubMed Lynch M, Higgins E, McCormick PA, Kirby B, Nolan N, Rogers S, Lally A, Vellinga A, Omar H, Collins P (2014) The use of transient elastography and FibroTest for monitoring hepatotoxicity in patients receiving methotrexate for psoriasis. JAMA Dermatol 150:856–862CrossRefPubMed
31.
Zurück zum Zitat Rizzo L, Calvaruso V, Cacopardo B, Alessi N, Attanasio M, Petta S, Fatuzzo F, Montineri A, Mazzola A, L'Abbate L, Nunnari G, Bronte F, Di Marco V, Craxi A, Camma C (2011) Comparison of transient elastography and acoustic radiation force impulse for non-invasive staging of liver fibrosis in patients with chronic hepatitis C. Am J Gastroenterol 106:2112–2120CrossRefPubMed Rizzo L, Calvaruso V, Cacopardo B, Alessi N, Attanasio M, Petta S, Fatuzzo F, Montineri A, Mazzola A, L'Abbate L, Nunnari G, Bronte F, Di Marco V, Craxi A, Camma C (2011) Comparison of transient elastography and acoustic radiation force impulse for non-invasive staging of liver fibrosis in patients with chronic hepatitis C. Am J Gastroenterol 106:2112–2120CrossRefPubMed
Metadaten
Titel
Impact of admission liver stiffness on long-term clinical outcomes in patients with acute decompensated heart failure
verfasst von
Kazunori Omote
Toshiyuki Nagai
Naoya Asakawa
Kiwamu Kamiya
Yusuke Tokuda
Tadao Aikawa
Arata Fukushima
Keiji Noguchi
Yoshiya Kato
Hirokazu Komoriyama
Mutsumi Nishida
Yusuke Kudo
Hiroyuki Iwano
Takashi Yokota
Toshihisa Anzai
Publikationsdatum
06.12.2018
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 6/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-018-1318-y

Weitere Artikel der Ausgabe 6/2019

Heart and Vessels 6/2019 Zur Ausgabe

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Komplette Revaskularisation bei Infarkt: Neue Studie setzt ein Fragezeichen

24.04.2024 ACC 2024 Nachrichten

Eine FFR-gesteuerte komplette Revaskularisation war in einer Studie bei Patienten mit akutem Myokardinfarkt und koronarer Mehrgefäßerkrankung klinisch nicht wirksamer als eine alleinige Revaskularisation der Infarktarterie.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.