Abstract 18138: Liver Stiffness Shown by Transient Elastography - Potential Marker for Liver Dysfunction in Heart Failure
Background: Several studies have reported the prognostic importance of liver function test (LFT) abnormalities in patients with heart failure (HF). Recently, we illustrated a strong association between liver stiffness (LS) assessed by transient elastography and right-sided filling pressure in HF patients. The aim of this study was to investigate whether LS is better for predicting outcome than LFTs.
Methods: We determined LS values using a Fibroscan® device prior to discharge in 157 HF patients (age 64±15 years, male 69%, LVEF 44±18%). Routine laboratory tests including LFTs (AST, ALT, GGT, ALP, LDH, total and direct bilirubin) and brain natriuretic peptide (BNP) measurements were also performed. Patients were followed for cardiac death or re-hospitalization for HF. Cox proportional-hazards regression was used to adjust for the effect of differences in covariates on clinical event rate. The incremental value for each measurement was assessed by comparing model χ2 statistics.
Results: Forty-three patients (27%) died or were hospitalized for decompensated HF after a median follow-up of 193 days (IQR: 88-302). Among the LFT results, GGT, ALP, and direct bilirubin were significant predictors of cardiac events along with LS. Even after adjustment for age, gender, eGFR, and BNP, those remained associated with high risk. However, after adding LS into the models, none of the LFT results remained associated with high risk (Table). Finally, in Cox regression analyses of cardiac events, the effects of clinical variables (age, gender, eGFR, BNP) were augmented more by LS (incremental χ2 = 34.83, p = 0.0002) than GGT (incremental χ2 = 25.02, p = 0.0001), ALP (incremental χ2 = 23.47, p <0.0001), and direct bilirubin (incremental χ2 = 24.88, p = 0.0001).
Conclusions: In this outcome study, LS showed a stronger association with outcome than conventional LFT results, indicating its potential as a marker for organ dysfunction in HF.
Author Disclosures: T. Taniguchi: None. T. Ohtani: None. T. Onishi: None. H. Kioka: None. Y. Tsukamoto: None. O. Yamaguchi: None. K. Toda: None. S. Nakatani: None. Y. Sawa: None. Y. Sakata: None.
- © 2014 by American Heart Association, Inc.