Splenic Volume Index Determined Using Computed Tomography upon Admission Is Associated with Readmission for Heart Failure Among Patients with Acute Decompensated Heart Failure

Abstract

The spleen is associated with inflammation, and the size of the spleen is affected by hemodynamic congestion and sympathetic stimulation. However, the association between splenic size and prognosis in patients with heart failure remains unknown. Between January 2015 and March 2017, we analyzed 125 patients with acute decompensated heart failure who were assessed by computed tomography (CT) on the day of admission. The spleen was measured by 3-dimensional CT and then the patients were assigned to groups according to their median splenic volume indexes (SpVi; splenic volume/body surface area). We then compared their baseline characteristics and rates of readmission for heart failure after one year. The median SpVi was 63.7 (interquartile range: 44.7-95.3) cm 3 /m 2 . Age did not significantly differ between the groups. Patients with a high SpVi had more significantly enlarged left atria and left ventricles. Multiple regression analysis identified significant positive correlations between SpVi and posterior wall thickness as well as left ventricular mass index. Kaplan-Meier analysis revealed lower event-free rates in the patients with a high, than a low SpVi (P = 0.041, log-rank test). After adjustment for potential cofounding factors, SpVi was independently associated with readmission for heart failure (Hazard ratio, 2.25; 95% confidence interval, 1.01-5.02; P = 0.047). In conclusion, increased splenic volume is independently associated with readmission for heart failure among patients with acute decompensated heart failure.

Cardio–Splenic Relationship in Patients Receiving Trans-Catheter Aortic Valve Replacement

“…Our study featured elderly Japanese patients, and it is worth acknowledging that the generalizability of our findings, especially with regard to the absolute values and the determination of the SVI cutoff points, to other patient populations remains uncertain. In this study, the SVI values displayed a wide range, akin to previous cohorts involving heart failure, likely attributable to the diversity of hemodynamic profiles [21,28] For example, in a recent study involving a stable heart failure cohort, the median SVI was 68.9 mL/m 2 , which was almost similar to our cohort [21].…”

“…In contrast, a different study, which included patients with decompensated heart failure, found that a higher SVI was associated with systemic congestion and subsequently a higher rate of heart failure recurrence [28]. These differing findings further underscore the complexity of the relationship between the SVI and clinical outcomes, which can be influenced by the specific patient population and clinical context under investigation [28].…”

Microglia-mediated inflammatory destruction of neuro-cardiovascular dysfunction after stroke

“…The spleen correlated with the inflammation closely, and hemodynamic congestion, and sympathetic stimulation would affect the size of the spleen (Maeda et al, 2021 ). However, the inflammation mechanisms require more investigation.…”