Sound touch elastography can detect liver stiffness linked with chronic heart failure: Study

The researchers reported, "Patients with reduced ejection fraction and ride-sided HF had significantly higher liver stiffness values than control group patients."

Heart failure can impact the health of other organs. This effect is known as cardiohepatic syndrome for the liver and includes liver congestion and hepatic artery hypoperfusion. STE is a modified shear wave elastography method that uses multiple acoustic radiation force impulses to target an extended region of interest. The resulting display is a real-time coloured stiffness map.

Against the above background, Jing-Wu Yang from Guangdong Second Provincial General Hospital in Guangzhou, China, and colleagues aimed to assess liver damage quantitatively in chronic HF with sound touch elastography.

According to the researchers, this is the first study to reveal a correlation between HF with reduced ejection fraction and liver stiffness.

The study included 150 patients and categorized them into distinct groups. These included patients with HF with reduced ejection fraction (HFrEF) groups (left ventricular ejection fraction ≤40%, n = 45), HF with mildly reduced ejection fraction (HFmrEF) groups (left ventricular ejection fraction between 41% and 49%, n = 40), and right-sided HF (RHF) groups (n = 25); and control (n = 40).

In all subjects, liver stiffness measurement (LSM) was performed by STE. The other hepatic parameters were also measured.

The study led to the following findings:

• Patients with mildly reduced ejection fraction increased slightly compared with the control group patients, sound touch elastography showed significantly higher stiffness values in patients with reduced ejection fraction and right-sided heart failure.
• The right atrial volume index and diameter of the hepatic veins were significantly greater in the right-sided heart failure patients compared with the healthy controls.
• Patients with reduced ejection fraction had lower left ventricular ejection fraction along with greater liver stiffness.
• Patients with reduced ejection fraction and right-sided heart disease showed increased glutamyl transpeptidase and alkaline phosphatase values.

The research team indicated that while sound touch elastography can detect and quantify the effect of CHF on the liver, severe liver congestion, and liver fibrosis should also be considered in this setting.

“Our findings offer some reference for the early management of liver damage in heart failure patients,” they concluded.

Reference:

Yang, J., Ma, L., Zhang, Z., Xiong, R., Meng, Q., Huang, H., Bo Zeng, W., Bai, T., & Wang, Z. (2023). Sound Touch Elastography for Noninvasive Assessment of Liver Stiffness in Patients With Chronic Heart Failure. The American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2023.09.058