Clinical significance of spleen stiffness in patients with acute decompensated heart failure.
Clinical significance of spleen stiffness in patients with acute decompensated heart failure.
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DOI：
10.1002/ehf2.13001
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发表时间：
2020-12
影响因子：
3.8
通讯作者：
Okumura Y
中科院分区：
文献类型：
--
作者：
Saito Y;Matsumoto N;Aizawa Y;Fukamachi D;Kitano D;Kazuto T;Tamaki T;Fujito H;Sezai A;Okumura Y
充血性脾肿大是急性失代偿性心力衰竭（ADHF）器官充血的典型症状。剪切波弹性成像 (SWE) 可以测量脾硬度 (SS)。我们假设 SS 可以量化脾充血的严重程度并预测 ADHF 的不良事件。该研究包括两个队列：血流动力学队列（62 名 HF 患者）和结果队列（115 名 ADHF 患者）。 SS 是在血流动力学队列中右心导管插入术的同一天通过二维 SWE 测量的。右心房压力 (RAP) 与 SS 独立相关（β = 0.32，P = 0.002）。出院前在结果队列中测量 SS。根据 SS 三分位值将 115 名患者分为三组。与第一个三分位组和第二个三分位组相比，第三个三分位 SS 组的严重三尖瓣反流患病率更高、N 末端 B 型利钠肽 (NT pro-BNP) 更高、右心室舒张直径更大。在中位随访 105 (77-135) 天期间，25 名患者发生不良事件（1 例死亡，24 例因心力衰竭再次住院）。第三个三分位数 SS 组的不良事件发生率显着较高 (P < 0.001)。在调整传统的验证风险评分、肝功能测试、肝脏硬度和估计的 RAP 后，较高的 SS 与不良事件独立相关。出院时 SS 的程度可作为残余脾充血的标志，可预测 ADHF 患者的不良事件。
Congestive splenomegaly is a classic sign of organ congestion in acute decompensated heart failure (ADHF). Shear wave elastography (SWE) allows the measurement of spleen stiffness (SS). We hypothesized that SS could quantify the severity of splenic congestion and predict adverse events in ADHF. This study included two cohorts: a haemodynamic cohort (62 HF patients) and an outcome cohort (115 ADHF patients). SS was measured by two‐dimensional SWE on the same day of right heart catheterization in the haemodynamic cohort. Right atrial pressure (RAP) independently correlated with SS (β = 0.32, P = 0.002). SS was measured in the outcome cohort before discharge. The 115 patients were divided into three groups on the basis of the tertile value of SS. The third tertile SS group had a higher prevalence of severe tricuspid regurgitation, higher N‐terminal B‐type natriuretic peptide (NT pro‐BNP), and larger right ventricular diastolic diameter, than had the first tertile group and the second tertile group. During a median follow‐up period of 105 (77–135) days, adverse events occurred in 25 patients (one death and 24 rehospitalizations for HF). The third tertile SS group had a significantly higher rate of adverse events (P < 0.001). A higher SS was independently associated with adverse events after adjusting for conventional validated risk score, liver function test, liver stiffness, and estimated RAP. The degree of SS at discharge can be used as a marker of residual splenic congestion, which is predictive of adverse events in patients with ADHF.
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影响因子：
20.1
作者：
Ismahil MA;Hamid T;Bansal SS;Patel B;Kingery JR;Prabhu SD
通讯作者：
Prabhu SD
影响因子：
3.8
作者：
Sawano M;Shiraishi Y;Kohsaka S;Nagai T;Goda A;Mizuno A;Sujino Y;Nagatomo Y;Kohno T;Anzai T;Fukuda K;Yoshikawa T
通讯作者：
Yoshikawa T
影响因子：
1.8
作者：
Albayrak, Eda;Server, Sadik
通讯作者：
Server, Sadik
影响因子：
5
作者：
MORIYASU, F;NISHIDA, O;UCHINO, H
通讯作者：
UCHINO, H
DOI：
10.1016/j.jcmg.2014.10.009
发表时间：
2015-03
期刊：
JACC. Cardiovascular imaging
影响因子：
--
作者：
Emami H;Singh P;MacNabb M;Vucic E;Lavender Z;Rudd JH;Fayad ZA;Lehrer-Graiwer J;Korsgren M;Figueroa AL;Fredrickson J;Rubin B;Hoffmann U;Truong QA;Min JK;Baruch A;Nasir K;Nahrendorf M;Tawakol A
通讯作者：
Tawakol A