Usefulness of Cardiac MetaIodobenzylguanidine Imaging to Improve Prognostic Power of the Model for End-Stage Liver Disease Scoring System in Patients With Mild-to-Moderate Chronic Heart Failure

Hakui, Hideyuki; Yamada, Takahisa; Tamaki, Shunsuke; Morita, Takashi; Furukawa, Yoichi; Iwasaki, Yusuke; Kawasaki, Masato; Kikuchi, Atsushi; Kondo, Takumi; Ishimi, Masashi; Sato, Yoshihiro; Seo, Masahiro; Ozaki, Tatsuhisa; Ikeda, Iyo; Fukuhara, Eiji; Sakata, Yasushi; Fukunami, Masatake

doi:10.1016/j.amjcard.2016.03.047

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…The MELD-XI and FIB-4 indices were calculated at discharge, as well. The MELD-XI score and FIB-4 index were calculated using the following formula, as previously reported: MELD-XI score = 11.76 × ln (creatinine [mg/dL]) + 5.11 × ln (total bilirubin [mg/dL]) + 9.44, 8,20 where ln means the natural logarithm. If a patient had a creatinine or bilirubin level lower than 1.0 mg/dL, the value of 1.0 mg/dL was entered into the calculations to prevent negative logarithmic values in the formula, and the calculated score was rounded.…”

Section: Measurementmentioning

confidence: 99%

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

et al. 2021

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Aims Cardiohepatic interactions have been a focus of attention in heart failure (HF). The model for end-stage liver disease excluding international normalized ratio (MELD-XI) score has been shown to be useful for predicting poor outcomes in patients with acute decompensated HF (ADHF). Furthermore, the fibrosis-4 (FIB-4) index, a simple marker to assess liver fibrosis, predicts adverse prognoses in patients with HF as well. However, there is little information available on the prognostic significance of the combination of the MELD-XI score and FIB-4 index in patients with ADHF and its association with left ventricular ejection fraction (LVEF) subgroup. Methods and results We prospectively studied 466 consecutive patients who were admitted for ADHF [HF with reduced LVEF (LVEF < 40%): n = 164, HF with mid-range LVEF (40% ≤ LVEF < 50%): n = 104, and HF with preserved LVEF (LVEF ≥ 50%): n = 198]. We calculated the MELD-XI score and FIB-4 indices at discharge. The primary endpoint was all-cause death (ACD). During the mean follow-up period of 2.8 years, 143 patients had ACD. In the multivariate Cox analysis, the MELD-XI score and FIB-4 index were independently associated with ACD. Patients were stratified into the following three groups according to the median value of MELD-XI score (=11) and FIB-4 index (=2.13): Group 1 had both a low MELD-XI score and a low FIB-4 index; Group 2 had either a high MELD-XI score (MELD-XI score ≥11) or a high FIB-4 index (FIB-4 index ≥2.13); and Group 3 had both a high MELD-XI score and a high FIB-4 index. Kaplan-Meier analysis revealed that Group 2 and Group 3 had a significantly greater risk of ACD than Group 1 [Group 2 vs. Group 1: adjusted hazard ratio, 2.48 (95% confidence interval: 1.75-3.53), P < 0.0001; Group 3 vs. Group 1: adjusted hazard ratio, 7.03 (95% confidence interval: 3.95-13.7), P < 0.0001]. In addition, the patients with both a higher MELD-XI score and FIB-4 index showed a significantly higher risk of ACD also in the patients with HF with reduced LVEF, HF with mid-range LVEF, and HF with preserved LVEF (all P < 0.0001). Conclusions The combination of MELD-XI score and FIB-4 index may be useful for stratifying patients at risk for ACD in patients with ADHF, irrespective of LVEF.

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Section: Measurementmentioning

confidence: 99%

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

et al. 2021

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“…1,7 Congestive hepatopathy 8,9 due to HF causes functional abnormalities of the liver, 10 and increased liver stiffness, measured by transient elastography, indicates higher mortality. [11][12][13][14][15] Liver dysfunction, such as the elevation of serum bilirubin, alkaline phosphatase, gamma-glutamyl transferase, aspartate aminotransferase (AST), and alanine aminotransferase (ALT), is frequent in HF related to reduced arterial perfusion and passive congestion and is associated with disease severity and prognosis. 7,9 In many HFpEF patients, fluid retention is less apparent in the periphery but occurs in the abdominal cavity.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] In addition, elevated central venous pressure and right atrial pressure may contribute to cholestatic abnormalities and impairment of hepatocyte function and liver reserve in HF patients. [8][9][10] On the other hand, not only previous imaging tests, [11][12][13][14][15] but also a simple score to evaluate liver fibrosis is desirable and required in HF patients. Recently, in patients with chronic liver failure, non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS) has begun to be used to assess liver fibrosis based on simple laboratory testing (age, body mass index, presence of diabetes, AST to ALT ratio, platelet counts, and albumin) in patients with NAFLD.…”

Section: Introductionmentioning

confidence: 99%

Liver fibrosis score predicts mortality in heart failure patients with preserved ejection fraction

et al. 2017

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AimsHeart failure with preserved ejection fraction (HFpEF) has several pathophysiological aspects, including stiffness and/or congestion of multiple organs. Poor prognosis is expected in heart failure patients with liver stiffness, which has recently been assessed by non‐alcoholic fatty liver disease fibrosis score (NFS; based on aspartate aminotransferase to alanine aminotransferase ratio, platelet counts, and albumin). We aimed to investigate the impact of NFS on prognosis of HFpEF patients, with consideration for the peripheral collagen markers such as procollagen type III peptide (PIIIP), type IV collagen 7S, and hyaluronic acid.Methods and resultsWe performed a prospective observational study. Consecutive 492 hospitalized HFpEF patients were divided into four groups based on their NFS: first–fourth quartiles (n = 123). The fourth quartile group had the highest levels of PIIIP, type IV collagen 7S, hyaluronic acid, and B‐type natriuretic peptide (P<0.001 each). In addition, there were significant positive correlations between PIIIP, type IV collagen 7S, hyaluronic acid, B‐type natriuretic peptide, and NFS (P < 0.001 each). In the follow‐up period (mean 1107 days), 93 deaths occurred. All‐cause mortality increased in all four quartiles (8.1%, 12.2%, 23.6%, and 31.7%, P < 0.001). In the multivariable Cox proportional hazard analysis, NFS was an independent predictor of all‐cause mortality in the HFpEF patients.ConclusionsNFS, a novel indicator of liver fibrosis, correlates with circulating systemic markers of fibrosis and congestion and is associated with higher all‐cause mortality in HFpEF patients. NFS can be calculated simply and may be a useful tool to assess liver stiffness and prognosis in HFpEF patients.

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“…In CABG patients grouped into low (<9), moderate (9)(10)(11)(12)(13)(14), and high (≥15) MELD classifications, an elevated MELD score displays a higher risk of perioperative morbidity and mortality [36]. Meanwhile, another study indicates that mild-to-moderate chronic heart failure patients with MELD scores ≥10 had a significantly higher incidence of cardiac death than those with MELD scores <10 [37]. Evidence shows that the ACS patients undergoing PCI were divided into two subgroups based on the cut-off point of the MELD score; low (≤7.3) and high subgroups (>7.3), the cardiac death (5.0% vs. 1.5%, p < 0.001), and all-cause total mortality (14% vs. 18%, p < 0.001) are higher in patients with high MELD score than those with low MELD score [9].…”

Section: Discussionmentioning

confidence: 99%

Model for End-Stage Liver Disease Score Predicts the Mortality of Patients with Coronary Heart Disease Who Underwent Percutaneous Coronary Intervention

Chen

Han

Zheng

et al. 2021

Cardiology Research and Practice

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Background. Coronary heart disease (CHD) is caused by the blockage or spasm of coronary arteries. Evidence shows that liver disease is related to CHD. However, the correlation between the Model for End-Stage Liver Disease (MELD) score and outcomes in patients after percutaneous coronary intervention (PCI) was unclear. Method. A retrospective cohort study involved 5373 patients with coronary heart disease after PCI was conducted from January 2008 to December 2016. Participants were classified to four groups according to the MELD score by quartiles. The primary endpoint was long-term mortality including all-case mortality (ACM) and cardiac mortality (CM). Secondary endpoints included bleeding events, readmission, major adverse cardiovascular events (MACE), major adverse cardiovascular, and cerebrovascular events (MACCE). The longest follow-up time was almost 10 years. Results. There were significant differences in the incidences of ACM ( p = 0.038 ) and CM ( p = 0.027 ) among the four MELD groups, but there was no significant difference in MACEs ( p = 0.496 ), MACCEs ( p = 0.234 ), readmission ( p = 0.684 ), and bleeding events ( p = 0.232 ). After adjusting the age, gender, smoking, drinking status, and diabetes by a multivariable Cox regression analysis, MELD remains independently associated with ACM (HR:1.57, 95%CI 1.052–2.354, p = 0.027 ) and CM (HR:1.434, 95% CI 1.003–2.050, p = 0.048 ). Conclusion. This study indicated that the MELD score had a strong prediction for long-term mortality in CHD patients who underwent PCI.

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Usefulness of Cardiac MetaIodobenzylguanidine Imaging to Improve Prognostic Power of the Model for End-Stage Liver Disease Scoring System in Patients With Mild-to-Moderate Chronic Heart Failure

Cited by 10 publications

References 20 publications

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

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

Liver fibrosis score predicts mortality in heart failure patients with preserved ejection fraction

Model for End-Stage Liver Disease Score Predicts the Mortality of Patients with Coronary Heart Disease Who Underwent Percutaneous Coronary Intervention

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