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Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure
BACKGROUND: It has been reported that liver stiffness assessed by transient elastography are correlated with right atrial pressure, which is associated with worse outcome in patients with heart failure (HF). We aimed to clarify clinical implications of hepatic hemodynamic evaluation (liver congestio...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792279/ https://www.ncbi.nlm.nih.gov/pubmed/32750309 http://dx.doi.org/10.1161/JAHA.120.016689 |
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author | Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Ichijo, Yasuhiro Sato, Yu Yokokawa, Tetsuro Misaka, Tomofumi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Takeishi, Yasuchika |
author_facet | Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Ichijo, Yasuhiro Sato, Yu Yokokawa, Tetsuro Misaka, Tomofumi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Takeishi, Yasuchika |
author_sort | Yoshihisa, Akiomi |
collection | PubMed |
description | BACKGROUND: It has been reported that liver stiffness assessed by transient elastography are correlated with right atrial pressure, which is associated with worse outcome in patients with heart failure (HF). We aimed to clarify clinical implications of hepatic hemodynamic evaluation (liver congestion and hypoperfusion) by abdominal ultrasonography in patients with HF. METHODS AND RESULTS: We performed abdominal ultrasonography, right‐heart catheterization, and echocardiography, then followed up for cardiac events such as cardiac death or worsening HF in patients with HF. Regarding liver congestion, liver stiffness assessed by shear wave elastography (SWE) of the liver was significantly correlated with right atrial pressure determined by right‐heart catheterization (R=0.343; P<0.01), right atrial end‐systolic area, and inferior vena cava diameter determined by echocardiography. Regarding liver hypoperfusion, peak systolic velocity (PSV) of the celiac artery was correlated with cardiac index determined by right‐heart catheterization (R=0.291; P<0.001) and tricuspid annular plane systolic excursion determined by echocardiography. According to the Kaplan–Meier analysis, HF patients with high SWE and low PSV had the highest cardiac event rate (log‐rank P=0.033). In the Cox proportional hazard analysis, high SWE and low PSV were associated with high cardiac event rate (high SWE: hazard ratio [HR], 2.039; 95% CI, 1.131–4.290; low PSV: HR, 2.211; 95% CI, 1.199–4.449), and the combination of high SWE and low PSV was a predictor of cardiac events (HR, 4.811; 95% CI, 1.562–14.818). CONCLUSIONS: Intrahepatic congestion and hypoperfusion determined by abdominal ultrasonography (liver SWE and celiac PSV) are associated with adverse prognosis in patients with HF. |
format | Online Article Text |
id | pubmed-7792279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77922792021-01-15 Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Ichijo, Yasuhiro Sato, Yu Yokokawa, Tetsuro Misaka, Tomofumi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Takeishi, Yasuchika J Am Heart Assoc Original Research BACKGROUND: It has been reported that liver stiffness assessed by transient elastography are correlated with right atrial pressure, which is associated with worse outcome in patients with heart failure (HF). We aimed to clarify clinical implications of hepatic hemodynamic evaluation (liver congestion and hypoperfusion) by abdominal ultrasonography in patients with HF. METHODS AND RESULTS: We performed abdominal ultrasonography, right‐heart catheterization, and echocardiography, then followed up for cardiac events such as cardiac death or worsening HF in patients with HF. Regarding liver congestion, liver stiffness assessed by shear wave elastography (SWE) of the liver was significantly correlated with right atrial pressure determined by right‐heart catheterization (R=0.343; P<0.01), right atrial end‐systolic area, and inferior vena cava diameter determined by echocardiography. Regarding liver hypoperfusion, peak systolic velocity (PSV) of the celiac artery was correlated with cardiac index determined by right‐heart catheterization (R=0.291; P<0.001) and tricuspid annular plane systolic excursion determined by echocardiography. According to the Kaplan–Meier analysis, HF patients with high SWE and low PSV had the highest cardiac event rate (log‐rank P=0.033). In the Cox proportional hazard analysis, high SWE and low PSV were associated with high cardiac event rate (high SWE: hazard ratio [HR], 2.039; 95% CI, 1.131–4.290; low PSV: HR, 2.211; 95% CI, 1.199–4.449), and the combination of high SWE and low PSV was a predictor of cardiac events (HR, 4.811; 95% CI, 1.562–14.818). CONCLUSIONS: Intrahepatic congestion and hypoperfusion determined by abdominal ultrasonography (liver SWE and celiac PSV) are associated with adverse prognosis in patients with HF. John Wiley and Sons Inc. 2020-07-30 /pmc/articles/PMC7792279/ /pubmed/32750309 http://dx.doi.org/10.1161/JAHA.120.016689 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Yoshihisa, Akiomi Ishibashi, Shinji Matsuda, Mitsuko Yamadera, Yukio Ichijo, Yasuhiro Sato, Yu Yokokawa, Tetsuro Misaka, Tomofumi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Takeishi, Yasuchika Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure |
title | Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure |
title_full | Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure |
title_fullStr | Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure |
title_full_unstemmed | Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure |
title_short | Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure |
title_sort | clinical implications of hepatic hemodynamic evaluation by abdominal ultrasonographic imaging in patients with heart failure |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792279/ https://www.ncbi.nlm.nih.gov/pubmed/32750309 http://dx.doi.org/10.1161/JAHA.120.016689 |
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