Splenic size as an indicator of hemodynamics and prognosis in patients with heart failure

Hiraiwa, Hiroaki; Okumura, Takahiro; Sawamura, Akinori; Araki, Takashi; Mizutani, Takashi; Kazama, S.; Kimura, Yuki; Shibata, Naoki; Oishi, Hideo; Kuwayama, Tasuku; Kondo, Toru; Fukui, Kenji; Morimoto, Ryo; Murohara, Toyoaki

doi:10.1007/s00380-022-02030-1

Cited by 5 publications

(9 citation statements)

References 42 publications

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“…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].…”

Section: Splenic Sizesupporting

confidence: 75%

“…To explore the connection between the SVI and clinical parameters in our cohort of TAVR candidates, we divided them into tertiles. In a prior study involving a stable heart failure cohort, a lower cardiac output, heightened sympathetic nerve activity, and hypoxia were found to be correlated with a decreased SVI [21]. Notably, the SVI exhibited an increase following enhancements in the cardiac output and the stabilization of sympathetic nerve activity through the implementation of durable left ventricular assist devices [29].…”

Section: Cardio-splenic Relationshipmentioning

confidence: 94%

“…One of the pivotal roles of the spleen is to function as a buffer for circulating blood [16]. In cases of a hypovolemic state such as cardiogenic shock, the spleen acts to construct and bolster the effective circulating fluid volume [17][18][19][20][21], while in congestive heart failure, it enlarges and strives to conserve fluid volume [22].…”

Section: Splenic Sizementioning

confidence: 99%

“…The spleen, which stockpiles approximately 30% of the total blood volume, serves as a buffer for the systemic fluid volume [16]. In circumstances where the effective circulating blood volume diminishes due to factors such as cardiogenic shock, sympathetic nervous system activation, or end organ ischemia, the spleen endeavors to contract as a means of preserving the systemic volume [17][18][19][20][21]. Conversely, in patients beset by systemic congestion, the spleen endeavors to enlarge itself to accommodate the additional blood influx necessitated by volume overload [22].…”

Section: Introductionmentioning

confidence: 99%

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

Imamura,

Fujioka,

Ushijima

et al. 2023

JCM

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Background: The spleen seems to be a significant buffer of the effective circulating blood volume by changing its size dramatically according to hemodynamics. The cardio–splenic relationship has been recently proposed in the literature regarding heart failure cohorts, and the splenic size has been proposed as a prognostic factor in these cohorts. However, the clinical implication of the splenic size in patients receiving trans-catheter aortic valve replacement (TAVR) remains unknown. Methods: Patients who underwent TAVR at our institute between 2015 and 2022 were eligible. Of these, the patients whose abdominal computed tomography imaging was obtained before TAVR were included. The volume of the spleen was measured in all the participants. The prognostic impact of the indexed splenic volume (SVI) on the 2-year cardiac death or heart failure readmissions was evaluated. Results: A total of 343 patients (86 years, 98 males) were included. The median value of the peak velocity at the aortic valve was 4.4 (4.0, 4.8) m/s and the median SVI was 65.5 (48.9, 86.9) mL/m2. A lower SVI tended to be associated with a lower cardiac output, whereas a higher SVI was associated with a higher plasma volume. The SVI was independently associated with the 2-year cardiac death or heart failure readmission after TAVR with a hazard ratio of 1.09 (95% confidence interval 1.01–1.18, p = 0.041), adjusted for potential confounders. A calculated cutoff of SVI was 70.2 mL/m2, which significantly stratified the cumulative incidence of the primary outcome (10% versus 4%, p = 0.033). Conclusion: A high baseline SVI, which was associated with systemic congestion, was associated with a higher incidence of cardiac death or heart failure readmission after TAVR. Further studies are warranted to clarify the detailed cardio–splenic relationship and implication of measuring the SVI in this cohort.

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Section: Splenic Sizesupporting

confidence: 75%

Section: Cardio-splenic Relationshipmentioning

confidence: 94%

Section: Splenic Sizementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Imamura,

Fujioka,

Ushijima

et al. 2023

JCM

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“…This study concluded that spleen measurements may help to estimate systemic volume status and to understand hemodynamics in patients with LVADs for heart failure. Another recent study has shown an association between spleen volume index and outcomes in patients with heart failure [ 65 ], supporting the spleen as a potentially useful prognostic indicator in heart failure.…”

Section: The Cardiosplenic Axis In Heart Failurementioning

confidence: 92%

The cardiosplenic axis: the prognostic role of the spleen in heart failure

2022

Self Cite

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Despite the number of available methods to predict prognosis in patients with heart failure, prognosis remains poor, likely because of marked patient heterogeneity and varied heart failure etiologies. Thus, identification of novel prognostic indicators to stratify risk in patients with heart failure is of paramount importance. The spleen is emerging as a potential novel prognostic indicator for heart failure. In this article, we provide an overview of the current prognostic tools used for heart failure. We then introduce the spleen as a potential novel prognostic indicator, before outlining the structure and function of the spleen and introducing the concept of the cardiosplenic axis. This is followed by a focused discussion on the function of the spleen in the immune response and in hemodynamics, as well as a review of what is known about the usefulness of the spleen as an indicator of heart failure. Expert insight into the most effective spleen-related measurement indices for the prognostication of patients with heart failure is provided, and suggestions on how these could be measured in clinical practice are considered. In future, studies in humans will be required to draw definitive links between specific splenic measurements and different heart failure manifestations, as well as to determine whether splenic prognostic measurements differ between heart failure classes and etiologies. These contributions will provide a step forward in our understanding of the usefulness of the spleen as a prognostic predictor in heart failure.

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Impact of the spleen size on short-term prognosis in patients with cardiogenic shock receiving Impella-incorporated temporary mechanical circulatory support

Nakamura,

Imamura,

Fujioka

et al. 2024

J Artif Organs

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Splenic size as an indicator of hemodynamics and prognosis in patients with heart failure

Cited by 5 publications

References 42 publications

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

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

The cardiosplenic axis: the prognostic role of the spleen in heart failure

Impact of the spleen size on short-term prognosis in patients with cardiogenic shock receiving Impella-incorporated temporary mechanical circulatory support

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