Clinical Study On The Value Of Liver Stiffness By ElastPQ To The Patients With Chronic Heart Failure

Background and objectionLiver is an important organ in human body.It has a unique vascular system which receives the dual blood supply of hepatic artery and portal vein and has a high metabolism.In patients with right heart failure(RHF),prolonged high right atrial pressure leads to enlargement of the right atrium.The pressure of the right atrium could be transmitted to the hepatic vein,widening the inner diameter of the inferior vena cava(IVC)and hepatic vein(HV),and leading to atrophy and necrosis of hepatic cells under pressure and hypoxia.In patients with Left heart failure(LHF),insufficient cardiac output can lead to hepatic hypoperfusion,followed by hepatic cell ischemia and hypoxia,thus resulting in ischemic liver damage.Venous congestion and hypoperfusion are the two basic mechanisms of liver damage caused by heart failure(HF).These two mechanisms often exist simultaneously,but the former dominates.HF often brings irreversible liver damage and liver fibrosis in varying degrees.Numbers of studies have shown that liver stiffness measurement(LSM)was extremely correlated with liver fibrosis.At present,most studies are researching about the relationship between RHF and LSM.There are few reports about the changes of LSM caused by LHF or whole heart failure(WHF).Elastography point quantification(Elast PQ)is a technique,which obtains elastic modulus values of different tissues according to the velocity of shear waves in different tissues.In this study,ElastPQ was used to evaluate the LSM of patients with chronic heart failure(CHF),helping clinicians to understand patients' conditions.MethodsA total of 58 patients with clinical stable CHF were studied.The patients,with cardiac function classification are ? level or higher,were divided into 3 groups:WHF group,n=20;LHF group,n=24;RHF group,n=14.All subjects had no history of liver damage and received ElastPQ,biochemicalmination,and the related parameters should be recorded.The LSM and other parameters were statistically analyzed.ResultsCompared with control group,patients in LHF group,RHF group and WHF had a statistical difference in LSM(P<0.05).LSM of those in RHF group and WHF group were significantly higher than that in the LHF group(P<0.05).The WHF group has the most high LSM in all group.There was a clear correlation among LSM with HV,IVC,right lobe of the liver(RL),brain natriuretic peptide(BNP),total bilirubin(T-bil)and y-glutamyl-transferase(?-GGT).Conclusion1.By using EIastPQ technology,we can estimate the influence and injury of the CHF on liver quantitatively through LSM.2.Although the two-dimensional liver ultrasound liver ultrasonography of patients with LHF is normal,the LSM is higher than normal people.3.Compared to healthy people,patients with CHF had a higher LSM,especially for those with RHF and WHF.4.The LSM of patients with CHF was correlated with HV,IVC,RL,BNP,Tbil and ?-GGT.