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

  • 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
Original Article
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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.

Keywords

Acute decompensated heart failure Liver stiffness Prognosis Venous congestion 

Notes

Acknowledgments

The authors are grateful to Kota Ohno, PhD, for statistical support.

Compliance with ethical standards

Conflict of interest

No conflict of interest to declare.

Supplementary material

380_2018_1318_MOESM1_ESM.docx (28 kb)
Supplementary file1 (DOCX 27 kb)

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Kazunori Omote
    • 1
  • Toshiyuki Nagai
    • 1
    • 2
  • Naoya Asakawa
    • 1
  • Kiwamu Kamiya
    • 1
  • Yusuke Tokuda
    • 1
  • Tadao Aikawa
    • 1
  • Arata Fukushima
    • 1
  • Keiji Noguchi
    • 3
  • Yoshiya Kato
    • 1
  • Hirokazu Komoriyama
    • 1
  • Mutsumi Nishida
    • 4
    • 5
  • Yusuke Kudo
    • 4
    • 5
  • Hiroyuki Iwano
    • 1
  • Takashi Yokota
    • 1
  • Toshihisa Anzai
    • 1
  1. 1.Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
  2. 2.National Heart and Lung Institute, Imperial College LondonLondonUK
  3. 3.Department of Cardiovascular MedicineHealth Sciences University of HokkaidoTobetsuJapan
  4. 4.Division of Laboratory and Transfusion MedicineHokkaido University HospitalSapporoJapan
  5. 5.Diagnostic Center for SonographyHokkaido University HospitalSapporoJapan

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