Influence of Left Ventricular Assist Devices on Liver Stiffness using Acoustic Radiation Force Impulse Imaging (ARFI) in Patients with End-Stage Chronic Heart Failure

Problemstellung: Chronic heart failure leads to liver congestion with progressive acceleration to liver fibrosis and may end in cardiac cirrhosis. The influence of left ventricular assist device (LVAD) on liver stiffness in patients with end-stage chronic heart failure. was not so far evaluated. Patienten und Methode: A total of 28 patients (mean age 54.4 ± 10.7 years, 5% females) with chronic heart failure were recruited in this study. 16 patients received tranjugular liver biopsy (TJLB). ARFI elastography of the liver was performed at baseline (n = 28), 21 days (n = 23, follow up 1) and 485 ± 136 days after LVAD implantation (n = 13, follow up 2). Hemodynamic and laboratory values were recorded. Ergebnisse: Liver stiffness significantly decreased from baseline to follow up 1 (n = 23, 1.88 ± 0.87 m/s to 1.43 ± 0.83 m/s, p < 0.001) and from baseline to follow up 2 (n = 13, 1.83 ± 0.69 m/s to 1.15 ± 0.61 m/s, p < 0.001). Moreover, brain natriuretic peptide (BNP) decreased significantly from baseline to follow up 1 (p < 0.001) and from baseline to follow up 2 (p = 0.004). At follow up 1 an inverse correlation was detected between ARFI and portal vein flow velocity (r =-0.616, p = 0.033) and between brain natriuretic peptide and portal vein flow velocity (r =-0.894, p < 0.001). Schlussfolgerungen: Liver stiffness is increased in chronic heart failure and reached normal values after LVAD implantation. Therefore, ARFI elastography might be useful in monitoring patients with chronic heart failure after LVAD implantation.