Liver Stiffness for Predicting Adverse Cardiac Events in Chinese Patients With Heart Failure: A Two-year Prospective Study

Abstract Background. To investigate whether liver stiffness (LS) can predict adverse cardiac events in Chinese patients with heart failure (HF). Methods. Total of 53 hospitalized patients with HF were enrolled and LS and tricuspid annual plane systolic excursion (TAPSE)were determined before discharge with Fibroscan® and Echocardiography. The patients were divided into two groups: High LS group(LS >6.9Kpa, n=23) and Low LS group(LS ≤6.9Kp, n=30) . Patients were followed up for 24 months at interval of 3 months. The endpoint of follow-up is death or rehospitalization for HF. Results. All patients were followed up for 24 months or until the endpoint. Patients in High LS group had lower platelet count(P=0.014), lower creatine clear rate (P=0.014), higher level of B-type natriuretic peptide at discharge(P=0.012), and lower tricuspid annual plane systolic excursion (P<0.001). During 24 months follow-up, 3(5.7%) deaths and 21(39.6%) hospitalization were observed. Patients in high LS group had a higher rate of death/rehospitalization when compared with patient in low LS group (Hazard ratio: 4.81; 95% confidence interval:1.69-13.7, P=0.003) after adjustment for age, sex, platelet count, creatine clear rate, and B-type natriuretic peptide level. Also, TAPSE≤16 can predict adverse cardiac events with HR of 6.63 (95% confidence interval:1.69-13.7, P=0.004) for age, sex, platelet count, creatine clear rate, and B-type natriuretic peptide level.Conclusion. LS and TAPSE may be considered for predicting worse outcomes for patients with heart failure.