Liver stiffness for predicting adverse cardiac events in chinese patients with heart failure: a two-year prospective study

Qian Wang,Yuqing Song,Song Yang,Qiming Wu,Qian Dong

doi:10.1186/s12872-022-02497-w

Abstract

BackgroundTo investigate whether liver stiffness (LS) can predict adverse cardiac events in Chinese patients with heart failure (HF).MethodsA total of 53 hospitalized patients with HF were enrolled, and LS and tricuspid annual plane systolic excursion (TAPSE) were determined with Fibroscan® and echocardiography before discharge. They were divided into two groups: high LS group (LS > 6.9 Kpa, n = 23) and low LS group (LS ≤ 6.9 Kpa, n = 30). Patients were followed up for 24 months at an interval of 3 months. The endpoint of follow-up was death or rehospitalization for HF.ResultsAll patients were followed up for 24 months or until the endpoint. Patients in the high LS group had lower platelet count (P = 0.014), lower creatine clear rate (P = 0.014), higher level of B-type natriuretic peptide at discharge (P = 0.012), and lower TAPSE (P < 0.001) than those in the low LS group. During 24 months of follow-up, 3 (5.7%) deaths and 21 (39.6%) hospitalizations for HF were observed. Patients in the high LS group had a higher rate of death/rehospitalization than those in the low LS group (Hazard ratio 4.81; 95% confidence interval 1.69–13.7, P = 0.003) after adjustment for age, sex, platelet count, creatine clear rate, and B-type natriuretic peptide level. Moreover, TAPSE ≤ 16 could predict adverse cardiac events with an HR of 6.63 (95% confidence interval 1.69–13.7, P = 0.004) after adjustment for age, sex, platelet count, creatine clear rate, and B-type natriuretic peptide level.ConclusionLS and TAPSE could be used to predict worse outcomes in patients with HF.

Highlights

To investigate whether liver stiffness (LS) can predict adverse cardiac events in Chinese patients with heart failure (HF)
Study population Patients were divided into two groups: High LS group (LS > 6.9 Kpa, n = 23) and low LS group (LS ≤ 6.9 Kpa, n = 30)
Kaplan–Meier curves showed that patients in the high LS group showed a higher risk of endpoint events than those in the low LS group (Fig. 1)

Summary

Introduction

To investigate whether liver stiffness (LS) can predict adverse cardiac events in Chinese patients with heart failure (HF). RV failure implies an increased risk of cardiac adverse events, regardless of the LS measurements with transient elastography (FibroScan®) were first developed to evaluate liver fibrosis noninvasively. Further studies show that decompensated HF may increase LS value measured by transient elastography [6], and LS may reflect right-side filling pressure in patients with HF [7]. Data about the efficacy of LS in predicting the long-term prognosis of HF patients are still limited. Data about the long-term follow-up of TAPSE and prognosis of Chinese patients are limited. In this study, we prospectively enrolled patients with HF at a tertiary hospital to evaluate the efficacy of LS and TAPSE in predicting 2-year adverse events

Methods

Results

Discussion

Conclusion