A prospective evaluation of hepatic parameters in congestive heart failure patients
Keywords:Heart failure, Hepatic parameters, Liver enzymes
Background: Heart failure is heterogeneous and complex clinical syndrome. Passive congestion of liver is associated with increase in direct and indirect serum bilirubin and elevated liver enzyme. Impaired perfusion due to decreased cardiac output is responsible for acute hepatocellular necrosis and serum aminotransferases will be elevated. Present study has been designed to study the prevalence of liver function abnormalities in heart failure patients, pattern of elevation of liver enzymes and correlation of liver function tests with etiology, duration and of heart failure.
Methods: All patients enrolled for this study was evaluated clinically and echocardiographically. Various demographic parameters like age sex duration of disease were recorded on predesigned Performa.
Results: Serum bilirubin was 3.76±1.62 mg/dl in class IV and least in class I that is 1.125±0.30 mg/dl. Serum AST was highest in class IV 154.64±24.96 IU and least in class I that is 36.21±12.65 IU (p=0.001). Serum ALT was highest in class IV 192.24±34.44 IU and least in class I that is 33.34±11.460 (p=0.001).
Conclusions: From present study we can conclude that heart failure was common in fifth and sixth decade of life and there was male predominance. Congested hepatomegaly was common presentation jaundice and ascites was also common. Change in biochemical parameters was increased with severity and duration of heart disease.
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure J Am College Cardiol. 2017;70(6):
Mann DL, Chakinala M. Heart failure pathophysiology and diagnosis, Harrisons principal of internal medicine, Mc Graw Hill publication,20th edition. 2018;286:1763.
Savarese G, Lund LH. Global Public Health Burden of Heart Failure, Card Fail Rev. 2017;3(1):7-11.
Lippi G, Sanchis-Gomar F. Global epidemio-logy and future trends of heart failure. AME Med J. 2020;5:15
Felder L, Mund A, Parker JG. Liver Function Tests in Chronic Congestive Heart Failure. Circulation. 1950;2:286-97.
El Hadi H, Di Vincenzo A, Vettor R, Rossato M. Relationship between Heart Disease and Liver Disease: A Two-Way Street. Cells. 2020;9(3):567.
Alvarez AM, Mukherjee D. Liver abnormalities in cardiac diseases and heart failure. Int J Angiol. 2011;20(3):135-42.
Møller S, Bernardi M. Interactions of the heart and the liver. Eur Heart J. 2013;34(36):2804-11.
Allen LA, Felker GM, Pocock S. Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program. Eur J Heart Fail. 2009;11(2):170-7.
Laribi S, Mebazaa A. Cardiohepatic syndrome: liver injury in decompensated heart failure. Curr Heart Fail Rep. 2014;11(3):236-40.
Xanthopoulos A, Starling RC, Kitai T, Triposkiadis F. Heart Failure and Liver Disease: Cardiohepatic Interactions. JACC Heart Fail. 2019;7(2):87-97.
Pendyal A, Gelow JM. Cardiohepatic Interactions: Implications for Management in Advanced Heart Failure. Heart Fail Clin. 2016;12(3):349-61.
Correale M, Tarantino N, Petrucci R, Tricarico L, Laonigro I, Di Biase M et al. Liver disease and heart failure: Back and forth. Eur J Intern Med. 2018;48:25-34.
Russell SD, Rogers J, Milano CA, Dyke DB, Pagani FD, Aranda JM et al. Renal and Hepatic Function Improve in Advanced Heart Failure Patients During Continuous-Flow Support with the HeartMate II Left Ventricular Assist Device. Circulation. 2009;120:2352-7.
Fouad YM, Yehia R. Hepato-cardiac disorders. World J Hepatol. 2014;6(1):41-54.
Auer J. What does the liver tell us about the failing heart? Eur Heart J. 2013;34(10):711-4.
Heuer M, Meyer M. When the heart kills the liver: acute liver failure in congestive heart failure. Eur J Med Res. 2009;14:541.
Yancy CW. 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128;16.
The Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels, 9th ed. Boston, Mass: Little, Brown & Co; 1994:253-6.
Shah SC, Sass DA. Cardiac Hepatopathy. A review of liver dysfunction in heart failure. Liver Res Open J. 2015;1(1):1-10.
Van deursen VM, Damman K, Hillege H, Van beek AP, Van veldhuisen DJ, Voors AA. Abnormal Liver Function in Relation to Hemodynamic Profile in Heart Failure Patients. J Cardiac Failure. 2010;16:1.
Nikolaou M, Parissis J, Yilmaz MB, Seronde M-F, Kivikko M, Laribi S et al Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure. Eur Heart J. 2013;34(10):742-9.
Samsky MD, Patel CB, De Wald TA, Smith AD, Felker GM, Rogers JG et al. Cardiohepatic Interactions in Heart Failure an Overview and Clinical Implications. JACC. 2013;61(24):2397-405.
Naschitz JE, Slobodin G, Lewis RJ, Zuckerman E, Yeshurun D. Heart diseases affecting the liver and liver diseases affecting the heart. Am Heart J. 2000;140(1):111-20.
Kubo SH, Walter BA, John DH, Clark M, Cody RJ. Liver function abnormalities in chronic heart failure. Influence of systemic hemodynamics. Arch Intern Med. 1987;147(7):1227-30.