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Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure
Background: It has been recently reported that liver stiffness assessed by transient elastography reflects right atrial pressure (RAP) and is associated with worse outcomes in patients with heart failure (HF). However, the relationship between shear wave dispersion (SWD, a novel indicator of liver v...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762121/ https://www.ncbi.nlm.nih.gov/pubmed/33291248 http://dx.doi.org/10.3390/jcm9123953 |
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author | Ohara, Himika Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Sugawara, Yukiko Ichijo, Yasuhiro Hotsuki, Yu Watanabe, Koichiro Anzai, Fumiya Sato, Yu Kimishima, Yusuke Yokokawa, Tetsuro Misaka, Tomofumi Sato, Takamasa Oikawa, Masayoshi Kobayashi, Atsushi Takeishi, Yasuchika |
author_facet | Ohara, Himika Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Sugawara, Yukiko Ichijo, Yasuhiro Hotsuki, Yu Watanabe, Koichiro Anzai, Fumiya Sato, Yu Kimishima, Yusuke Yokokawa, Tetsuro Misaka, Tomofumi Sato, Takamasa Oikawa, Masayoshi Kobayashi, Atsushi Takeishi, Yasuchika |
author_sort | Ohara, Himika |
collection | PubMed |
description | Background: It has been recently reported that liver stiffness assessed by transient elastography reflects right atrial pressure (RAP) and is associated with worse outcomes in patients with heart failure (HF). However, the relationship between shear wave dispersion (SWD, a novel indicator of liver viscosity) determined by abdominal ultrasonography and RAP, and the prognostic impact of SWD on HF patients have not been fully examined. We aimed to clarify the associations of SWD with parameters of liver function test (LFT) and right heart catheterization (RHC), as well as with cardiac events such as cardiac death and worsening HF, in patients with HF. Methods: We performed abdominal ultrasonography, LFT and RHC in HF patients (n = 195), and followed up for cardiac events. We examined associations between SWD and parameters of LFT and RHC. Results: There were significant correlations between SWD and circulating levels of direct bilirubin (R = 0.222, p = 0.002), alkaline phosphatase (R = 0.219, p = 0.002), cholinesterase (R = −0.184, p = 0.011), and 7S domain of collagen type IV (R = 0.177, p = 0.014), but not with RAP (R = 0.054, p = 0.567) or cardiac index (R = −0.015, p = 0.872). In the Kaplan–Meier analysis, cardiac event rate was significantly higher in the high SWD group (SWD ≥ 10.0 (m/s)/kHz, n = 103) than in the low SWD group (SWD < 10.0 (m/s)/kHz, n = 92; log-rank, p = 0.010). In the Cox proportional hazard analysis, high SWD was associated with high cardiac event rates (hazard ratio, 2.841; 95% confidence interval, 1.234–6.541, p = 0.014). In addition, there were no interactions between SWD and all subgroups, according to the subgroup analysis. Conclusions: SWD assessed by abdominal ultrasonography reflects liver fibrosis rather than liver congestion, and is associated with adverse prognosis in HF patients. |
format | Online Article Text |
id | pubmed-7762121 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-77621212020-12-26 Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure Ohara, Himika Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Sugawara, Yukiko Ichijo, Yasuhiro Hotsuki, Yu Watanabe, Koichiro Anzai, Fumiya Sato, Yu Kimishima, Yusuke Yokokawa, Tetsuro Misaka, Tomofumi Sato, Takamasa Oikawa, Masayoshi Kobayashi, Atsushi Takeishi, Yasuchika J Clin Med Article Background: It has been recently reported that liver stiffness assessed by transient elastography reflects right atrial pressure (RAP) and is associated with worse outcomes in patients with heart failure (HF). However, the relationship between shear wave dispersion (SWD, a novel indicator of liver viscosity) determined by abdominal ultrasonography and RAP, and the prognostic impact of SWD on HF patients have not been fully examined. We aimed to clarify the associations of SWD with parameters of liver function test (LFT) and right heart catheterization (RHC), as well as with cardiac events such as cardiac death and worsening HF, in patients with HF. Methods: We performed abdominal ultrasonography, LFT and RHC in HF patients (n = 195), and followed up for cardiac events. We examined associations between SWD and parameters of LFT and RHC. Results: There were significant correlations between SWD and circulating levels of direct bilirubin (R = 0.222, p = 0.002), alkaline phosphatase (R = 0.219, p = 0.002), cholinesterase (R = −0.184, p = 0.011), and 7S domain of collagen type IV (R = 0.177, p = 0.014), but not with RAP (R = 0.054, p = 0.567) or cardiac index (R = −0.015, p = 0.872). In the Kaplan–Meier analysis, cardiac event rate was significantly higher in the high SWD group (SWD ≥ 10.0 (m/s)/kHz, n = 103) than in the low SWD group (SWD < 10.0 (m/s)/kHz, n = 92; log-rank, p = 0.010). In the Cox proportional hazard analysis, high SWD was associated with high cardiac event rates (hazard ratio, 2.841; 95% confidence interval, 1.234–6.541, p = 0.014). In addition, there were no interactions between SWD and all subgroups, according to the subgroup analysis. Conclusions: SWD assessed by abdominal ultrasonography reflects liver fibrosis rather than liver congestion, and is associated with adverse prognosis in HF patients. MDPI 2020-12-06 /pmc/articles/PMC7762121/ /pubmed/33291248 http://dx.doi.org/10.3390/jcm9123953 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ohara, Himika Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Sugawara, Yukiko Ichijo, Yasuhiro Hotsuki, Yu Watanabe, Koichiro Anzai, Fumiya Sato, Yu Kimishima, Yusuke Yokokawa, Tetsuro Misaka, Tomofumi Sato, Takamasa Oikawa, Masayoshi Kobayashi, Atsushi Takeishi, Yasuchika Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure |
title | Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure |
title_full | Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure |
title_fullStr | Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure |
title_full_unstemmed | Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure |
title_short | Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure |
title_sort | shear wave dispersion predicts liver fibrosis and adverse outcomes in patients with heart failure |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762121/ https://www.ncbi.nlm.nih.gov/pubmed/33291248 http://dx.doi.org/10.3390/jcm9123953 |
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