Clinical significance of spleen stiffness in patients with acute decompensated heart failure

Abstract

Aims 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. Methods and Results 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. Conclusions 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.

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

“…We did not employ shear-wave elastography, an alternative method for assessing the splenic function by measuring splenic stiffness. In previous research, splenic stiffness was found to correlate with right atrial pressure, and high splenic stiffness was associated with future occurrences of cardiac death or heart failure recurrence in heart failure cohorts [32].…”

Liver stiffness for predicting adverse cardiac events in chinese patients with heart failure: a two-year prospective study

“…Besides LS measured by Fibroscan, Fibrosis-4 and non-alcoholic fatty liver disease fibrosis scores have also been used to predict the prognosis of HF patients [ 19 , 20 ]. Moreover, recently, Saito et al found that spleen stiffness measured by two-dimensional shear-wave elastography could be used to predict the prognosis of patients with HF [ 21 ]. In addition, abdominal viscera stiffness is also promising for predicting the prognosis of HF patients.…”

Prognostic Value of Liver Stiffness Measured by Two-Dimensional Elastography in Acute Decompensated Heart Failure with Preserved Ejection Fraction

“…Echocardiography: Echocardiography was performed before discharge by experienced sonographers blinded to other clinical data, as previously described. 22) LV diastolic dysfunction and left atrial diameter were measured in the parasternal long-axis view, and LVEF was measured using the modified Simpson method or the Teichholz method. The RV end-diastolic diameter (RVDd) was measured at the basal ventricular level of the RV in end-diastole.…”