From congestive hepatopathy to hepatocellular carcinoma, how can we improve patient management?

Sessa, Anna; Allaire, Manon; Lebray, Pascal; Medmoun, Mourad; Tiritilli, A.; Iaria, P.; Cadranel, Jean–François

doi:10.1016/j.jhepr.2021.100249

Cited by 20 publications

(23 citation statements)

References 92 publications

(152 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The development of chronic liver injury secondary to right cardiac decompensation in particular is well known [6, 8]. Interestingly, however, this seems to be independent from the additional NAFLD development in patients with PH.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary hypertension is associated with an increased incidence of NAFLD: A retrospective cohort study of 18,910 patients

et al. 2021

View full text Add to dashboard Cite

Background Pulmonary hypertension (PH) represents a multicausal disease with increasing global incidence that eventually leads to right ventricular failure. In addition to cardiac sequelae, noncardiac comorbidities appear to be of increasing relevance, especially in times of improved therapeutic options that often result in long‐term survival. Here, we examined a potential association between PH and nonalcoholic fatty liver disease (NAFLD) as well as liver cirrhosis in an outpatient cohort in Germany. Methods A total of 9455 PH patients followed in general and internist practices between 2005 and 2019 were matched by propensity scoring based on age, sex, yearly consultation frequency and relevant comorbidities (obesity, diabetes, heart failure, lipid metabolism disorders) to a cohort of equal size without PH. The association between PH and NAFLD/liver cirrhosis was evaluated using Cox regression models. Results Within 10 years from the index date, cumulative incidence rates of NAFLD were significantly higher amongst patients with PH (7.3%) compared to non‐PH patients (3.5%, log‐rank p < 0.001). In regression analysis, this association was significant for both female (HR: 1.93, p < 0.001) and male (HR: 1.51, p = 0.005) patients and was most prominent amongst patients > 80 years (HR: 3.30, p = 0.001). Moreover, PH patients showed a strong trend towards higher incidence rates of liver cirrhosis compared to non‐PH patients (1.4 vs. 1.1%, p = 0.066). Conclusion Our data suggest that incidence rates of NAFLD are strongly elevated in patients with PH. This finding should trigger awareness of noncardiac comorbidities in these patients and argues for potential liver‐directed screening programs in patients with PH.

show abstract

Section: Discussionmentioning

confidence: 99%

Pulmonary hypertension is associated with an increased incidence of NAFLD: A retrospective cohort study of 18,910 patients

et al. 2021

View full text Add to dashboard Cite

show abstract

“…hepatopathy (2), but also for their participation in improving the knowledge of this disease by identifying diabetes as an independent predictive factor of graft failure and mortality after combined heart-liver transplantation (CHLT) (3). We fully agree that careful selection of the patients with congestive hepatopathy who will benefit from CHLT is mandatory in the era of organ shortage and with regard to the survival observed after such a procedure.…”

mentioning

confidence: 88%

Reply to: “Combined heart-liver transplantation for congestive hepatopathy with bridging fibrosis: Is it warranted?”

et al. 2021

Self Cite

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…The prevalence of FALD is not well defined as of yet. Probably, liver deterioration starts immediately after Fontan surgery, with the total cava-pulmonary connection that may induce: systemic venous congestion, non-pulsatile pulmonary perfusion, and reduced cardiac preload and output [7]. This may lead to a progressive, time-related, damage and failure of systemic organs; in particular, liver stiffness (LS) may appear increased up to values that define liver cirrhosis [8].…”

Section: Introductionmentioning

confidence: 99%

Role of Transient Elastography to Stage Fontan-Associated Liver Disease (FALD) in Adults with Single Ventricle Congenital Heart Disease Correction

Chemello

Padalino

Zanon

et al. 2021

JCDD

View full text Add to dashboard Cite

Fontan-associated liver disease (FALD) is an arising clinical entity that can occur long after a successful Fontan operation for correction of single ventricle (SV) congenital heart disease (CHD). Occurrence of FALD is characterized by liver cirrhosis and other hepatic complications, and determinates an increased morbidity and mortality. Currently, there is no consensus on how to stage FALD. We report here our experience by an observational study in 52 patients with SV-CHD after Fontan operation that were recruited through a period of 36 ± 9.3 months. All cases underwent lab tests and liver and cardiac imaging evaluation, including liver stiffness (LS) measurement by transient elastography (TE) (FibroScan®). According to selective criteria for liver disease, we identified 23/43 (53.5%) cases with advanced FALD that showed: older age (p < 0.05), larger hepatic and cava veins diameter (p < 0.05), worsened NYHA class (p < 0.05), abnormal lymphocytes (p < 0.01), platelet count (p < 0.05), and GGT, prothrombin time (INR), albumin and cystatin C levels (p < 0.05), with respect to cases without advanced FALD. LS values were significantly increased in cases with advanced FALD, at cut-off values higher than 22 kPa (p < 0.001). LS, and its combined score with spleen diameter and platelet count (LSPS) successfully helped to detect 100% of cases with portal hypertension (p < 0.001). In conclusion, LS can be effective to stage FALD and to uncover cases with severe risk of complications, avoiding higher morbidity and mortality related to advanced FALD.

show abstract

From congestive hepatopathy to hepatocellular carcinoma, how can we improve patient management?

Cited by 20 publications

References 92 publications

Pulmonary hypertension is associated with an increased incidence of NAFLD: A retrospective cohort study of 18,910 patients

Pulmonary hypertension is associated with an increased incidence of NAFLD: A retrospective cohort study of 18,910 patients

Reply to: “Combined heart-liver transplantation for congestive hepatopathy with bridging fibrosis: Is it warranted?”

Role of Transient Elastography to Stage Fontan-Associated Liver Disease (FALD) in Adults with Single Ventricle Congenital Heart Disease Correction

Contact Info

Product

Resources

About