Liver stiffness and arterial stiffness/abnormal central hemodynamics in the early stage of heart failure

Abstract

BackgroundIt remains to be clarified whether liver stiffness is a direct risk factor for heart failure (HF) or whether its association with HF is mediated by vascular damage. We conducted cross-sectional and prospective longitudinal studies to examine whether fibrosis 4 score (FIB-4 score) is directly associated with the serum NT-pro-BNP levels or the association is mediated by arterial stiffness and/or abnormal central hemodynamics.Methods and resultsIn 3040 health Japanese subjects with serum NT-pro-BNP levels < 125 pg/ml, the FIB-4 score was calculated, and the serum NT-pro-BNP levels, brachial-ankle pulse wave (baPWV) velocity and radial augmentation index (rAI) were measured. These parameters were measured again after a 3-year interval in 2135 subjects. Multivariate linear regression analysis demonstrated a significant cross-sectional association of the FIB-4 scores with the log-transformed the serum NT-pro-BNP levels (beta = 0.08, p < 0.01), but not with the baPWV or rAI. The change of serum NT-pro BNP levels during the study period was significantly higher in subjects with increase of the FIB-4 score during the study period (8.2 ± 22.5 pg/ml) than that in those with decrease/no change (5.4 ± 22.3 pg/ml) (p < 0.05).ConclusionLiver stiffness may have a significant direct association with the development of HF from the early stage, without the mediation of arterial stiffness and/or abnormal central hemodynamics. Therefore, the FIB-4 score appears to serve as a direct risk factor for HF from the early stage, and its association with HF may not be mediated by vascular damages.

Prognostic value of impaired hepato‐renal function and liver fibrosis in patients admitted for acute heart failure

“…Increased hepatic venous pressure causes hepatocyte atrophy and oedema of the peripheral area in the liver, which provokes liver damage. The mechanism is known as hypoxic hepatopathy 21,22 . Hypoxic hepatopathy leads to acute hepatocellular necrosis and causes liver stiffness 23 .…”

Possible Mechanisms Underlying Elevated Serum N-Terminal Pro-Brain Natriuretic Peptide in Healthy Japanese Subjects

“… 21 , 22 Thus, both increased cardiac afterload and increased cardiac preload could be associated with elevated secretion of natriuretic peptide. Except in our previous study, 23 the relationship between the cardiac preload and serum BNP/NT-proBNP has never been clarified in healthy subjects. In our previous study, conducted in the same cohort as that used for the present study, markers of the cardiac afterload (i.e., AI, PP2 and brachial-ankle PWV) and the abdominal compartment, which might be associated with elevation of the cardiac preload, as assessed on FIB-4 score, 9 were significantly associated with serum NT-proBNP.…”

“…In our previous study, conducted in the same cohort as that used for the present study, markers of the cardiac afterload (i.e., AI, PP2 and brachial-ankle PWV) and the abdominal compartment, which might be associated with elevation of the cardiac preload, as assessed on FIB-4 score, 9 were significantly associated with serum NT-proBNP. 23 …”

<p>Hepatic Fibrosis Assessed Using Fibrosis-4 Index Is Predictive of All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease</p>

“…[10][11][12] Besides evaluating chronic liver diseases, FIB-4 has been used to assess liver fibrosis and its relation with other systemic inflammatory diseases or conditions, including arterial stiffness/abnormal central hemodynamics in heart failure, cerebral white matter hyperintensity, rheumatoid arthritis, and polyangiitis. [13][14][15][16][17] Accordingly, we investigated whether liver fibrosis assessed using FIB-4 is associated with all-cause mortality in patients with COPD, based on the concept that liver fibrosis might be a sequela of hepatic or systemic inflammation.…”