Decompensated Chronic Heart Failure: Increased Liver Stiffness Measured by Means of Transient Elastography
Decompensated Chronic Heart Failure: Increased Liver Stiffness Measured by Means of Transient Elastography
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DOI：
10.1148/radiol.10100013
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发表时间：
2010-12-01
期刊：
影响因子：
19.7
通讯作者：
Prati, Daniele
中科院分区：
文献类型：
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作者：
Colli, Agostino;Pozzoni, Pietro;Prati, Daniele
目的：分析急性失效的心力衰竭患者的瞬时弹性学测量的肝脏僵硬，以描述肝脏僵硬度测量的变化并评估其与患者的临床过程和实验室数据的关系。材料和方法：这项研究得到了局部制度的批准审核委员会和所有受试者均给予了口头知情同意。 27例住院的心力衰竭患者没有肝病迹象（平均年龄，79岁+/- 12 [标准偏差]； 12名男性[平均年龄，78岁+/- 11]，15名女性[平均年龄，80岁年+/- 12]）接受肝僵硬和N末端β脑发脂肽（NTPRO Beta BNP）评估，并在入院时进行了24例患者，并在出院时进行了僵硬的测量。 （入院时有三名患者的测量失败；其中两个未在出院时进行测量，一名死亡的患者仅获得了入院值。）预定义的刚度截止值大于7.65 kPa，用于实质性纤维化，大于13.01 kpa的kPa。肝硬化。对照受试者是21例不受心力衰竭或肝病影响的患者。通过使用两尾Wilcoxon，Mann-Whitney或T测试比较这两组。 14例（58％）的病例大于7.65 kPa，五个（21％）大于13.01 kPa。在住院期间，18例患者（包括所有五名基线测量> 13.01 kPa）的肝僵硬降低，5例升高。肝僵硬（P <.003）和NTPROβBNP（p <.001）在住院期间均显着降低。在所有对照患者中，肝僵硬度小于7.65 kPa，在住院期间没有显着变化（p = .261）。结论：大多数急性急性代偿性心力衰竭的患者具有高肝僵硬值，例如NTPROβBNP水平，往往会降低与（c）RSNA，2010年
Purpose: To analyze transient elastography-measured liver stiffness in patients with acute decompensated heart failure to describe variations in liver stiffness measurements and assess their relationship with the patients' clinical course and laboratory data.Materials and Methods: This study was approved by the local institutional review board, and all of the subjects gave verbal informed consent. Twenty-seven hospitalized patients with heart failure with no signs of liver disease (mean age, 79 years +/- 12 [standard deviation]; 12 men [mean age, 78 years +/- 11], 15 women [mean age, 80 years +/- 12]) underwent liver stiffness and N-terminal pro beta brain natriuretic peptide (NTpro beta BNP) assessments at admission, and 24 patients underwent stiffness measurements at discharge. (Three patients had failed measurement at admission; two of whom did not undergo measurement at discharge and one patient who died had only an admission value obtained.) The predefined stiffness cutoff values were greater than 7.65 kPa for substantial fibrosis and greater than 13.01 kPa for cirrhosis. The control subjects were 21 patients unaffected by heart failure or liver disease. The two groups were compared by using two-tailed Wilcoxon, Mann-Whitney, or t tests, as appropriate.Results: Among the patients with heart failure, median liver stiffness at admission was 8.80 kPa (interquartile range, 5.92-11.90 kPa), greater than 7.65 kPa in 14 (58%) cases and greater than 13.01 kPa in five (21%). During hospitalization, liver stiffness decreased in 18 patients (including all five patients with baseline measurement > 13.01 kPa) and increased in five. Median liver stiffness (P < .003) and NTpro beta BNP (P < .001) levels both significantly decreased during hospitalization. Liver stiffness was less than 7.65 kPa in all control patients and did not significantly change during hospitalization (P = .261).Conclusion: Most patients with acute decompensated heart failure have high liver stiffness values which, like NTpro beta BNP levels, tend to decrease with (C) RSNA, 2010