Archives of the Turkish Society of Cardiology
Liver stiffness value obtained with ElastPQ ultrasound is increased by NYHA class in chronic heart failure patients with reduced ejection fraction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-62282 | DOI: 10.5543/tkda.2018.62282

Liver stiffness value obtained with ElastPQ ultrasound is increased by NYHA class in chronic heart failure patients with reduced ejection fraction

Yahya Kemal Icen1, Abdullah Orhan Demirtas1, Ayse Selcan Koc2, Hilmi Erdem Sumbul3, Mevlut Koc1
1University of Health Sciences - Adana Health Practice and Research Center, Department of Cardiology, Adana, Turkey
2University of Health Sciences - Adana Health Practice and Research Center, Department of Radiology, Adana, Turkey
3University of Health Sciences - Adana Health Practice and Research Center, Department of Internal Medicine, Adana, Turkey


OBJECTIVE
Liver stiffness (LS) values are known to be associated with increased right ventricle (RV) pressure in patients with heart failure (HF). In our study, it was aimed to determine the changes in LS in NYHA classes and parameters related with increased LS in HF patients with reduced ejection fraction (HFrEF).

METHODS
181 patients with HFrEF were included in the study. Routine anamnesis, physical examination, laboratory examinations and echocardiography were performed. In addition, LS measurement was performed with the ElastPQ technique. Patients were grouped by NYHA class.

RESULTS
The LS values were significantly different between all NYHA classes. LS values were found to be significantly increasing from NYHA class I to IV and the highest LS values were found in class IV patient. Similarly, the number of patients with LS >7kPa and >10.6kPa was significantly higher in class III-IV patient. RV myocardia performance index, tricuspid regurgitation pressure gradient, NT-proBNP and aspartate aminotransferase levels were found to be independently associated with LS. It was found that LS independently determined the presence of class III-IV and that the increase of 1kPa increased the risk of being class III-IV by 94.4%. In the ROC analysis, when the cut-off value for LS was taken as 7kPa, it was determined the patients with class III-IV disease with 82.8% sensitivity and 81.8% specificity.

CONCLUSION
In HFrEF, the LS value increases with increasing NYHA class and independently determines patients with class III-IV disease. The increased LS value independently determines the increased RV pressure and systolic functions.

Keywords: Heart failure with reduced ejection fraction, liver stiffness, ventricular systolic function, functional capacity

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Corresponding Author: Mevlut Koc, Türkiye
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