RT Journal Article
SR Electronic
A1 Vyskocilova, Klaudia
A1 Spinarova, Lenka
A1 Spinar, Jindrich
A1 Mikusova, Tereza
A1 Vitovec, Jiri
A1 Malek, Josef
A1 Malek, Filip
A1 Linhart, Ales
A1 Fedorco, Marian
A1 Widimsky, Petr
A1 Cihalik, Cestmir
A1 Parenica, Jiri
A1 Littnerova, Simona
A1 Jarkovsky, Jiri
T1 Prevalence and clinical significance of liver function abnormalities in patients with acute heart failure
JF Biomedical papers
YR 2015
VO 159
IS 3
SP 429
OP 436
DO 10.5507/bp.2014.014
UL https://biomed.papers.upol.cz/artkey/bio-201503-0016.php
AB Aims: Liver pathology caused by cardiac dysfunction is relatively well recognized, however, its clinical importance has not been fully evaluated. The aim of this study was to assess the prevalence of liver function tests (LFTs) abnormalities and to identify associated factors mediating hepatic impairment in patients with acute heart failure (AHF).
Methods: The AHEAD (Acute Heart Failure Database) registry is a database conducted in 9 university hospitals and 5 regional health care facilities in the Czech Republic. From December 2004 to October 2012, the data of 8818 patients were included. The inclusion criteria for the database followed the European guidelines for AHF. Serum activities of all LFTs and total bilirubin were available in 1473 patients at the baseline.
Results: In patients with AHF, abnormal LFTs were seen in 76% patients (total bilirubin in 34%, γ-glutamyltransferase in 44%, alkaline phosphatase in 20%, aspartate aminotransferase in 42%, alanine aminotransferase in 35%). Patients with cardiogenic shock were more likely to have LFTs abnormalities compared to mild AHF and pulmonary oedema. LFTs abnormalities were strongly associated with AHF severity (left ventricular ejection fraction and NYHA functional class) and clinical manifestation. While hepatocellular LFTs pattern predominated in left sided forward AHF, cholestatic profile occurred mainly in bilateral and right sided AHF. Additionally, patients with moderate to severe tricuspid regurgitation had significantly higher prevalence of abnormalities in cholestatic LFTs.
Conclusions: Defining the LFTs profile typical for AHF plays an important role in management of AHF patients, since it may avoid redundant hepatic investigations and diagnostic misinterpretations.