AimThe impact of cardiac dysfunction on the liver is known as cardiac hepatopathy. In certain instances this can result in significant hepatic fibrosis or cirrhosis. The validity of non-invasive tools to assess hepatic fibrosis, such as FibroScan w which measures liver stiffness (LSM), has not been established in this setting. We examined the impact of cardiac dysfunction on LSM using FibroScan w and the influence of volume changes on LSM.
Methods and resultsA prospective, cross-sectional study examined the use of FibroScan w in subjects with left-sided heart failure (LHF, n ¼ 32), right-sided heart failure (RHF, n ¼ 9), and acute decompensated heart failure (ADHF, n ¼ 8). The impact of volume changes upon LSM was further examined in the ADHF group (pre-and post-diuresis) and in a haemodialysis group (HD, n ¼ 12), pre-and post-ultrafiltration on dialysis. Compared with healthy controls [n ¼ 55, LSM ¼ median 4.4 (25th percentile 3.6, 75th percentile 5.1) kPa], LSM was increased in all the cardiac dysfunction subgroups [LHF, 4.7 (4.0,8.7) kPa, P ¼ 0.04; RHF, 9.7 (5.0, 10.8) kPa, P , 0.001; ADHF, 11.2 (6.7, 14.3) kPa, P , 0.001]. Alteration in volume status via diuresis did not change the baseline LSM in ADHF [11.2 (6.7, 14.3) to 9.5 (7.3, 21.6) kPa, P . 0.05] with mean diuresis 5051 + 1585 mL, or ultrafiltration in HD [6.0 (3.6, 5.1) vs. 5.7 (4.8,7.0) kPa, P . 0.05] with mean diuresis 1962 + 233 mL.
ConclusionOur findings support the concept of increased LSM in the cardiac failure population. LSM was not altered to a statistically significant level with acute volume changes.--