Liver stiffness measurements and short-term survival after left ventricular assist device implantation: A pilot study

Potthoff, Andrej; Schettler, Anna; Attia, Dina; Schlué, Jérôme; Schmitto, Jan D.; Fegbeutel, Christine; Strüber, Martin; Haverich, Axel; Manns, Michael P.; Wedemeyer, Heiner; Gebel, M.; Schneider, Andrea L.C.

doi:10.1016/j.healun.2015.05.022

Cited by 20 publications

(27 citation statements)

References 28 publications

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“…4,10 In addition, LS has been shown to be an excellent short and long-term predictor of survival in various settings ranging from the emergency room up to treatment response in viral hepatitis. [11][12][13][14] Interestingly, a decrease of LS either during a pharmacological or TIPS intervention seems to predict a favorable outcome. 12,15 Longitudinal studies in patients undergoing treatment for chronic hepatitis B and C infection showed that patients were less likely to experience liver-related events if LS had decreased over time.…”

Section: Introductionmentioning

confidence: 99%

<p>Prospective Comparison of Transient Elastography Using Two Different Devices: Performance of FibroScan and FibroTouch</p>

Serra

Mueller

Teng

et al. 2020

HMER

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Purpose: Transient elastography (TE) using FibroScan (FS) has been established to noninvasively assess liver fibrosis and steatosis. The aim of this study was to compare the recently introduced FibroTouch (FT) device with the established FS with respect to liver stiffness and CAP. Patients and Methods: Thirty-nine patients with and without liver disease were included. All patients were measured three times with FS (FibroScan 530 compact, Echosens, France) and FT (FibroTouch-FT100, Wuxi Hisky Med, China). For FS, M and XL probe were used according to the manufacturer's specifications. For steatosis, CAP and the comparable FT equivalent UAP (ultrasound attenuation parameter) was determined. Finally, FT and FS were explored in liver tissue-mimicking phantoms. Results: LS between FS and FT correlated well with r=0.91. Root-mean-square (RMS) of the coefficient of variation for LS was better in FS (11.1% vs 27.4%). Bland-Altman analysis showed a 3.1 kPa mean overestimation of LS by FT. In addition, UAP strongly and linearly depended on the BMI following UAP=3.02 × BMI+186. In phantoms, a similar relation was found with UAP (phantom)= 3.78 × BMI + 146 suggesting that UAP is directly calculated from entered BMI instead of assessing shear-wave attenuation. Consequently, RMS-CV was lower for FT (6.0% vs 9.7%). However, if using different BMI, CV-RMS for FT increased to 12.7%. LS of a patient with manifest liver cirrhosis and ascites was 38.8 kPa using the FS-XL probe but almost normal with FT (7.2 kPa). Conclusion: Although LS by FT shows good correlation with LS-FS, it has larger variation, continuously overestimates LS and completely fails in ascites. Moreover, FT-UAP seems to be a misleading parameter for steatosis assessment because it is at least in part calculated from mandatory entered patient data. In conclusion, novel LS cutoff values need to be defined for LS-FT and usage of UAP is not recommended.

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Section: Introductionmentioning

confidence: 99%

<p>Prospective Comparison of Transient Elastography Using Two Different Devices: Performance of FibroScan and FibroTouch</p>

Serra

Mueller

Teng

et al. 2020

HMER

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“…В последующем пилотном исследовании у 10 пациентов с ДСН авторами обнаружены взаимосвязи значения плотности печени с наличием дилатации НПВ (r=0,7, p=0,03) [10]. В нескольких исследованиях при инвазивной оценке внутрисердечной гемодинамики показана корреляция плотности печени с давлением в правых отделах [11][12][13]21]. При сравнении диагностической ценности НЭ у 31 пациента, госпитализированного с ДСН, установлено, что плотность печени являлась более чувствительным и специфичным маркером увеличения давления в правом предсердии по сравнению с его оценкой при ЭхоКГ (площадь под кривой (AUC) составила 0,958 и 0,800 соответственно, p=0,047) [13].…”

Section: Discussionunclassified

“…Kardiologiia. 2018;58(S10): [20][21][22][23][24][25][26][27][28][29][30][31][32] Summary Objective: There is growing evidence that liver stiffness (LS) in decompensated heart failure (DHF) is related to congestion, however data about its impact on outcomes are limited. The aim of the study was to evaluate associations and long-term prognostic significance of LS measured by transient elastography (TE) in DHF.…”

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confidence: 99%

Prognostic value of liver stiffness in decompensated heart failure: results of prospective observational transient elastography-based study

Soloveva¹,

Kobalava²,

Villevalde³

et al. 2018

CARDIO

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Прогностическое значение плотности печени при декомпенсации сердечной недостаточности: результаты проспективного наблюдательного исследования, основанные на данных непрямой эластометрии Ключевые слова: декомпенсация сердечной недостаточности, непрямая эластометрия, плотность печени, застойная гепатопатия, прогноз

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“…In this cohort, patients who had RVF or needed RVAD support following LVAD implantation were characterized by significantly higher LS. Although significantly higher preoperative LS was demonstrated recently in non-survivors after LVAD implantation, the relationship between LS and RVF was not investigated and it was not clarified whether preoperative LS could predict post-LVAD RVF [16, 17]. Because LS is immediately influenced by changes in CVP, serial assessments of LS would contribute to perioperative optimization of right-sided filling pressure without a pulmonary catheter study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular function using liver stiffness in patients with left ventricular assist device†

Koibuchi

Toda

Nakamura

et al. 2017

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES: Although right ventricular failure (RVF) is a major concern after left ventricular assist device (LVAD) implantation, methodologies to evaluate RV function remain limited. Liver stiffness (LS), which is closely related to right-sided filling pressure and may indicate RVF severity, could be non-invasively and repeatedly assessed using transient elastography. Here we investigated the suitability of LS as a parameter of RV function in pre- and post-LVAD periods. METHODS: The study included 55 patients with LVAD implantation as a bridge to transplantation between 2011 and 2015 whose LS was assessed using transient elastography. RESULTS: Seventeen patients presented with RVF, defined as requiring inotropic support for ≥30 days, nitric oxygen inhalation for ≥5 days, and/or mechanical RV support following LVAD implantation. Survival of patients with RVF was significantly worse compared with that of patients without RVF. Multivariate logistic regression analysis identified preoperative LS, LV diastolic dimension, RV stroke work index, and dilated phase of hypertrophic cardiomyopathy aetiology as significant risk factors; the combination of these parameters could improve predictive power of post-LVAD RVF with areas under the curve of 0.89. Furthermore, LS was significantly decreased by LV unloading and significantly correlated with right-sided filling pressure. CONCLUSIONS: In addition to dilated hypertrophic cardiomyopathy aetiology, reduced RV stroke work index and small LV dimension, we demonstrated that non-invasively measured LS was a predictor of post-LVAD RVF and can be used as a parameter for the evaluation and optimization of RV function in the perioperative period.

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Liver stiffness measurements and short-term survival after left ventricular assist device implantation: A pilot study

Cited by 20 publications

References 28 publications

<p>Prospective Comparison of Transient Elastography Using Two Different Devices: Performance of FibroScan and FibroTouch</p>

<p>Prospective Comparison of Transient Elastography Using Two Different Devices: Performance of FibroScan and FibroTouch</p>

Prognostic value of liver stiffness in decompensated heart failure: results of prospective observational transient elastography-based study

Evaluation of right ventricular function using liver stiffness in patients with left ventricular assist device†

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