ISSN 1016-5169 | E-ISSN 1308-4488
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The Relationship between the Presence of Cardiohepatic Syndrome and Mortality in Heart Failure with Reduced Ejection Fraction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2024; 52(3): 167-173 | DOI: 10.5543/tkda.2023.25477

The Relationship between the Presence of Cardiohepatic Syndrome and Mortality in Heart Failure with Reduced Ejection Fraction

Mustafa Azmi Sungur1, Aylin Sungur2, Aycan Esen Zencirci1
1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
2Department of Cardiology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye


OBJECTIVE
Heart failure (HF) is a major health burden that commonly affects liver function. Therefore, cardiohepatic syndrome (CHS) has been defined to describe the relationship between the heart and the liver. In this study, we aimed to evaluate the effect of CHS on long-term mortality in HF with reduced ejection fraction (HFrEF).


METHODS
Patients followed at the outpatient HF clinic of our hospital with HFrEF between 2010 and 2018 were retrospectively analyzed. CHS was defined as elevation of at least two of three cholestasis parameters (total bilirubin, alkaline phosphatase, and gamma-glutamyl transferase) above the upper limit of normal. Patients were divided into two according to the presence of CHS. The endpoint was all-cause mortality. Patients were followed up for a median of 4.4 (3.3–5.9) years.


RESULTS
A total of 469 patients were included in the study. The mean age of the group was 52.2 ± 11.9 years and 75.5% of the patients were males. About 22.4% (n = 105) of the patients had CHS. Patients with CHS were older and had more comorbidities than patients without CHS. Furthermore, significantly worse left and right ventricular functions were observed in CHS (+) group. All-cause mortality was significantly higher in CHS (+) group (61.9% vs. 19.5%, P < 0.001). Multivariate analysis revealed the presence of CHS (HR: 2.92, 95% CI: 2.09–4.07, P < 0.001) as an independent predictor of long-term mortality.


CONCLUSION
The presence of CHS is associated with increased long-term mortality in outpatients with HFrEF. As an easy parameter to assess from routine laboratory parameters, CHS should be used to evaluate the long-term prognosis of patients with HFrEF.

Keywords: Alkaline phosphatase, cardiohepatic syndrome, gamma-glutamyl transferase, heart failure with reduced ejection fraction, mortality, total bilirubin

How to cite this article
Mustafa Azmi Sungur, Aylin Sungur, Aycan Esen Zencirci. The Relationship between the Presence of Cardiohepatic Syndrome and Mortality in Heart Failure with Reduced Ejection Fraction. Turk Kardiyol Dern Ars. 2024; 52(3): 167-173

Corresponding Author: Mustafa Azmi Sungur
Manuscript Language: English


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Journal Citation Indicator: 0.18
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SCImago Journal Rank: 0.348

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