Liver stiffness measurements and short-term survival after left ventricular assist device implantation: A pilot study
Section snippets
Methods
This prospective study was performed in compliance with the Declaration of Helsinki and with approval from the local Ethics Committee. Written informed consent was obtained from all patients. The study evaluated 61 patients indicated for LVAD implantation due to chronic HF. Of those patients, 33 did not fulfil the inclusion criteria because an ARFI measurement was not feasible due to their severe illness or death before LVAD implantation. Thus, 28 patients were enrolled upon referral to the
Characteristics of the study cohort
The study enrolled 28 patients (23 male), who were a mean age of 54 ± 11 years. Overall, the mean LS measurement in the cohort using ARFI was increased (mean 2.50 ± 0.92 m/sec). Group II patients (n = 24) showed significantly higher baseline LS compared with Group I patients (p < 0.001). LS and baseline characteristics of the study cohort are described in Table 1. At baseline, ALT, AST, GLDH, ALP, platelets, and cholinesterase were in the normal range. Serum γ-GT, bilirubin, creatinine, HA, and
Discussion
This prospective study assessed LS measurement by ARFI elastography before and after LVAD implantation and illustrated the effect of end-stage chronic HF on LS in the presence of liver congestion secondary to pulmonary and systemic congestion. Importantly, using ARFI, we demonstrated that liver stiffness normalized in patients who underwent LVAD implantation as a bridging or permanent therapy.
The leading pathophysiology of hepatic dysfunction in end-stage chronic HF is not fully understood.1
Disclosure statement
A.P. and M.G. have participated in studies on ARFI elastography and received lecture fees supported by Siemens Healthcare AG (Munich). None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose. A.S. contributed equally.
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These authors have contributed equally to this work.