Breaking News
April 20, 2018 - Discovery of 100 new genes may aid research into pigmentation
April 20, 2018 - AYOXXA introduces new LUNARIS Mouse 12-Plex Th17 Kit for quantitative analysis of Th17 cell biology
April 20, 2018 - Compound derived from immune cells treats psoriasis in mice
April 20, 2018 - GABA-transaminase deficiency – Genetics Home Reference
April 20, 2018 - Key heart risks decline for older Americans
April 20, 2018 - UD professor wins $2.3 million grant from NIH for research on Achilles tendinopathy
April 20, 2018 - Researchers discover unique protein in malaria parasite that could be new drug target
April 20, 2018 - Bio-Techne expands automation capabilities of popular RNAscope ISH technology
April 20, 2018 - Smartphone app effective in promoting proper child car seat practices
April 20, 2018 - FDA Alert: Certain Kratom-Containing Powder Products by Viable Solutions: Recall -Possible Salmonella Contamination
April 20, 2018 - What is heart failure?
April 20, 2018 - TIP Biosystems introduces handheld UV-Visible spectrophotometer for photometric measurements
April 20, 2018 - Inactivity of astronauts during spaceflights may have more pronounced effect on skeletal muscle than hypoxia
April 20, 2018 - New SIDS Info app seeks to reduce infant sleep-related deaths
April 20, 2018 - Wide-scale distribution of naloxone effectively prevents overdose deaths, study finds
April 20, 2018 - Triple-negative breast cancer found to be chemoresistant prior to treatment
April 20, 2018 - ACL tears occur the same way in women and men, study finds
April 20, 2018 - UT Southwestern researchers identify 170 potential therapeutic targets for lung cancer
April 20, 2018 - Finding the ‘keyhole’ to beat obesity at the cellular level
April 20, 2018 - Long-term exposure to cold temperatures reduces diabetes and obesity, shows study
April 20, 2018 - Metabolic Syndrome Common With Chronic Hep B Infection
April 20, 2018 - Tracking quality of life during prostate cancer treatment
April 20, 2018 - Study shows presence of beta-amyloid dimers in the brains of Alzheimer’s patients
April 20, 2018 - Researchers identify link between physical inactivity and increased risk of dying from cancer
April 20, 2018 - Breathtaking evolution amongst Indonesian tribe
April 20, 2018 - Study shows testosterone deficiency in men is associated with chronic diseases
April 20, 2018 - Simple one-page form helps improve satisfaction of patients with care
April 20, 2018 - Researchers evaluate accuracy of simple blood test to predict lung cancer
April 20, 2018 - Study looks at sperm producing ability in testicular cancer patients
April 20, 2018 - Exercise In, Vitamin D Out for Preventing Falls: U.S. Panel
April 20, 2018 - Skin cancers associated with decreased risk of developing AD
April 20, 2018 - Preserving fertility during chemotherapy
April 20, 2018 - Teva and Procter & Gamble Company terminate PGT Healthcare partnership
April 20, 2018 - People diagnosed with traumatic brain injury may have increased risk of Parkinson’s disease, shows study
April 20, 2018 - Researchers use smartphone to diagnose people infected with Loa loa worm
April 20, 2018 - College students with autism have high rate of suicidal thoughts
April 20, 2018 - Study sheds light on how the HSC niche is maintained
April 20, 2018 - Drug test spurs frank talk between hypertension patients and doctors
April 19, 2018 - Low-cost deworming drug improves female farmers’ physical fitness
April 19, 2018 - Genome editing identifies neural circuit behind leptin’s anti-obesity and anti-diabetes effects
April 19, 2018 - Many European countries lack comprehensive policy to eliminate viral hepatitis
April 19, 2018 - Young people with ADHD ‘more likely’ to come from deprived neighbourhoods
April 19, 2018 - SLU professor discovers new biomarkers for chlorine gas exposure
April 19, 2018 - Study proposes new mechanism that may contribute to gender differences in weight control
April 19, 2018 - Sleep restriction therapy does not interfere with insomnia patient’s driving ability, research shows
April 19, 2018 - Deep brain stimulation offers relief to UTHealth patient with treatment-resistant depression
April 19, 2018 - Study shows fatty fish and camelina oil boost HDL and IDL cholesterol
April 19, 2018 - FDA Alert: Euphoric Capsules by Epic Products: Recall
April 19, 2018 - Researchers identify peptide produced during cartilage deterioration as a potential source of osteoarthritis pain
April 19, 2018 - New breakthrough may allow scientists to orchestrate tissue regeneration in humans
April 19, 2018 - SYGNIS AG introduces new TruePrime apoptotic cell free DNA amplification kit
April 19, 2018 - Innovative device shows promise in capturing and releasing circulating tumor cells
April 19, 2018 - Researchers shed light on role of striosomal neurons in reinforcement learning
April 19, 2018 - Genetic make-up impacts long-term effectiveness of phobia treatment
April 19, 2018 - Novel biomarker can distinguish malignant lung nodules
April 19, 2018 - Study reports promising novel approach to treat therapy resistant pediatric brain tumors
April 19, 2018 - One-Hour Plasma Glucose Useful Predictor of Diabetic Retinopathy
April 19, 2018 - Hydroxychloroquine no more effective than placebo for relieving osteoarthritis hand pain
April 19, 2018 - Transplanted livers have a protective effect and reduce potential for organ rejection
April 19, 2018 - Researchers develop new method to study activity of inflammatory cells
April 19, 2018 - Researchers discover highly antibiotic resistant superbugs in Gulf States
April 19, 2018 - Smart-tooth technology shows promise in detecting certain diseases in high-risk patients
April 19, 2018 - Interaction between dioxin and HLA gene variant activates events associated with rheumatoid arthritis
April 19, 2018 - Eyes of adolescents could be associated with increased risk of cardiovascular disease in later life
April 19, 2018 - U.S. Women Less Likely Than Men to Get Statins After Heart Attack
April 19, 2018 - Health Canada grants cannabis cultivation license to High Park Farms
April 19, 2018 - Atypical brain development observed in preschoolers with ADHD symptoms
April 19, 2018 - SC Johnson releases annual Sustainability Report
April 19, 2018 - Positive attitudes about aging reduce risk of dementia in older adults
April 19, 2018 - Environmental pollutants found to worsen rheumatoid arthritis
April 19, 2018 - UT Southwestern scientists discover protein linked to metastatic breast cancer
April 19, 2018 - Study highlights need for further evidence to improve symptom management in end of life care
April 19, 2018 - Detecting diminished dopamine-firing cells inside brain could reveal earliest signs of Alzheimer’s
April 19, 2018 - Uniqsis offers high-power LED light unit for scalable flow photochemistry reactions
April 19, 2018 - Case study shows how intravascular ultrasound imaging helps detect acute aortic syndrome
April 19, 2018 - Research reveals new mechanism by which HIV evades the immune system
April 19, 2018 - Nanodisc-delivered cancer treatment helps eliminate tumors
April 19, 2018 - Functional connectivity MRI could help detect brain disorders and diseases
April 19, 2018 - Finding better way to quantify neuropathy symptoms and treatment efficacy
April 19, 2018 - Study examines effectiveness of caregiver education about sickle cell trait
The Stiffer the Liver, The Worse the HF Prognosis

The Stiffer the Liver, The Worse the HF Prognosis

image_pdfDownload PDFimage_print

As a proxy for liver congestion, liver stiffness measured with ultrasound elastography has important prognostic value among patients with heart failure, a Japanese study suggested.

Patients in the highest tertile of liver stiffness were at higher risk of mortality and heart failure rehospitalization (HR 3.57, 95% CI 1.93-6.83) over follow-up of more than 6 months, Tomohito Ohtani, MD, PhD, of Osaka University Graduate School of Medicine, and colleagues reported in their study published online in JACC: Cardiovascular Imaging.

For a model predicting 90-day cardiac events, a 10.1 kPa threshold for liver stiffness had sensitivity and specificity of 0.73 and 0.90, respectively, and a C-statistic of 0.823 (95% CI 0.682-0.964). Adding liver stiffness to a model consisting of age, gender, eGFR, and brain natriuretic peptide levels raised the C-statistic from 0.704 to 0.844 (P=0.006).

“Taken together, these results suggest that the assessment of liver congestion at discharge may aid in the management of heart failure patients,” Ohtani’s group concluded, saying it could “be used as a reliable indicator of subclinical residual liver congestion, which reflects the severity of heart failure, and of adverse cardiac events, even in patients with optimized heart failure treatment and without visible edema or elevated liver function test.”

The Fibroscan transient elastography device provided liver stiffness readings for 171 hospitalized heart failure patients at Osaka University Hospital. Excluded were those with invalid liver stiffness measures (8% of those screened in the hands of a single experienced examiner), liver disease, or a history of alcohol abuse.

Median liver stiffness was 5.6 kPa, which translates to a right-sided filling pressure of 5.7 mm Hg. A liver stiffness reading over 6.9 kPa (corresponding to an estimated right-sided filling pressure of over 7.1 mm Hg) placed patients in the highest tertile.

The stiffest livers were more likely to be observed in patients with moderate-to-severe heart failure, larger inferior vena cava diameter, higher serum direct bilirubin, and more concentrated brain natriuretic peptide levels. Multivariable adjustment still yielded a significant relationship between liver stiffness and heart failure outcomes.

Ohtani and colleagues acknowledged that no confirmatory liver biopsies were done, however, and that their sample size was quite small.

Even so, an accompanying editorial said that “one of the main strengths of liver stiffness is summarized in the methodology of this study: the authors performed only one analysis of liver stiffness per patient, at the discharge, and were able to glean numerous clinically significant results. This reminds us of the simplicity of use of this imaging tool: it is done at the patient’s bed, in a short time, and can be carried out by any doctor or specialist nurse practitioner.”

“The higher the liver stiffness, the greater the risk of the patient to die. Stone liver, heart in danger, is in a way, the message of this work,” according to editorialists Mathieu Pernot, PhD, and Olivier Villemain, MD, both of Institut Langevin in Paris.

“But probably future clinical studies will tell us whether decreasing liver stiffness can improve the prognosis of heart failure patients,” they added. “And in this case, we will have new and valuable arguments for implementing therapeutic strategies to reduce hepatic congestion monitored by elastography, which will change our clinical practice. Thanks to the liver, we could have the means to better understand the right heart.”

Ohtani, Pernot, and Villemain listed no relevant conflicts of interest.

2018-01-17T17:30:00-0500

Tagged with:

About author

Related Articles