Abnormal Liver Function in Relation to Hemodynamic Profile in Heart Failure Patients

V. M. Van Deursen, K. Damman, H. L. Hillege, A. P. Van Beek, D. J. Van Veldhuisen, A. A. Voors*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

195 Citations (Scopus)

Abstract

Background: We studied the relation between liver function abnormalities and hemodynamic profile in patients with heart failure (HF).

Methods and Results: in 323 HF patients, liver function was determined by aspartate and alanine aminotransferase (AST, ALT), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), lactate dehydrogenase, and direct and total bilirubin (Bili dir, Bili tot). Central venous pressure (CVP) and cardiac index (CI) were determined invasively. Follow-up consisted of time to all-cause mortality. Mean age was 53 +/- 15 Years, and 60% were male. In multivariable analysis, all liver function tests related to CVP, but higher CVP was predominantly related to GGT (r = 0.336, P <.001) and Bili dir (r = 0.370, P <.001). Only elevated AST (r = -0.177, P <.01), ALT (r = -0.130, P <.05), and Bill tot (r = -0.158, P <.01) were associated with both low CI and elevated CVP. The prognostic value of abnormal liver function tests was related to their interaction with CI and CVP.

Conclusions: Elevated liver function tests mainly indicate higher CVP, whereas only the presence of elevated AST. ALT, or Bili dir may indicate a low Cl. The absence of prognostic information in the presence of invasive hemodynamic measurements suggests that abnormal liver function tests in HF reflect a poor hemodynamic status. (J Cardiac Fail 2010:16:84-90)

Original languageEnglish
Pages (from-to)84-90
Number of pages7
JournalJOURNAL OF CARDIAC FAILURE
Volume16
Issue number1
DOIs
Publication statusPublished - Jan-2010

Keywords

  • Heart failure
  • abnormal liver function
  • hemodynamics
  • prognosis
  • BROAD-SPECTRUM
  • RENAL-FUNCTION
  • MORTALITY
  • DISEASE
  • ASSOCIATION
  • DYSFUNCTION
  • PROGRAM

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