Value of Virtual Touch Quantification Elastography for Assessing Liver Congestion in Patients With Heart Failure.
Value of Virtual Touch Quantification Elastography for Assessing Liver Congestion in Patients With Heart Failure.
复制标题
虚拟触摸量化弹性成像评估心力衰竭患者肝脏充血的价值。
DOI：
10.1253/circj.cj-15-1200
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
H. Tsutsui
中科院分区：
文献类型：
--
作者：
T. Yoshitani;Naoya Asakawa;M. Sakakibara;Keiji Noguchi;Yusuke Tokuda;K. Kamiya;H. Iwano;S. Yamada;Y. Kudou;M. Nishida;Chikara Shimizu;T. Amano;H. Tsutsui
背景
心力衰竭(HF)会导致器官充血，这被认为会增加器官硬度。虚拟触摸定量(VTQ)方法可用于评估慢性肝病患者的肝脏硬度。本研究旨在用VTQ测量肝脏和肾脏的硬度，并确定其在评估心力衰竭患者器官充血方面的价值。
方法和结果
10例正常人和38例心衰患者(年龄52.3±16.7岁，左心室射血分数27.0±9.4%，血浆B型利钠肽1,297.3±1,155.1pg/ml)。我们调查了临床特征和血流动力学以及肝和肾硬度之间的关系，并评估了药物治疗对这些测量的影响。肝硬化组(1.17±0.13m/S)显著高于正常对照组(2.03±0.91m/S，P=0.004)，肾硬挺度与对照组无显著差异(P>0.05)。中心静脉压(P=0.021)和脑钠素(P=0.025)是心衰患者肝脏僵硬增加的独立预测因素。肝硬度由治疗前的2.37±1.09降至1.27±0.33m/S(P<；0.001)。单因素分析显示，心衰患者肝脏硬度的变化与中心静脉压(R=0.636，P=0.014)和心脏指数(R=-0.557，P=0.039)的变化显著相关；多因素分析显示，心衰患者的中心静脉压变化与中心静脉压的变化显著相关。
结论
非侵入性VTQ方法测量的肝脏硬度可用于评估心衰患者的肝脏充血和治疗效果。(保监会J 2016；80：1187-1195)。
BACKGROUND
Heart failure (HF) causes organ congestion, which is thought to increase organ stiffness. The virtual touch quantification (VTQ) method can be used to assess liver stiffness in patients with chronic liver diseases. This study aimed to measure liver and kidney stiffness using VTQ and to determine its value for assessing organ congestion in patients with HF.
METHODSANDRESULTS
This study included 10 normal subjects and 38 HF patients (age 52.3±16.7 years, left ventricular ejection fraction 27.0±9.4%, plasma B-type natriuretic peptide [BNP] 1,297.3±1,155.1 pg/ml). We investigated the relationships between clinical characteristics and hemodynamics and liver and kidney stiffness, and assessed the effects of medical treatment on these measurements. Liver stiffness was significantly higher in HF patients (1.17±0.13 m/s vs. 2.03±0.91 m/s, P=0.004) compared with normal subjects, but kidney stiffness was similar in both groups. Central venous pressure (CVP) (P=0.021) and BNP (P=0.025) were independent predictive factors for increased liver stiffness in HF patients. Liver stiffness decreased significantly from 2.37±1.09 to 1.27±0.33 m/s (P<0.001) after treatment. Changes in liver stiffness in HF patients significantly correlated with changes in CVP (R=0.636, P=0.014) and cardiac index (R=-0.557, P=0.039) according to univariate analysis, and with changes in CVP in multivariate analysis.
CONCLUSIONS
Liver stiffness measured by noninvasive VTQ methods can be used to assess liver congestion and therapeutic effects in patients with HF. (Circ J 2016; 80: 1187-1195).
影响因子：
13.5
作者：
Castera, Laurent;Foucher, Juliette;de Ledinghen, Victor
通讯作者：
de Ledinghen, Victor