Non-invasive assessment of hepatic steatosis and fibrosis and echocardiographic parameters of the function of the right ventricle.

UNLABELLED: The gold standard for assessing liver fibrosis is core needle biopsy. Its invasive nature, however, limits its wide use. Hence the need for non-invasive methods in patients with hepar venostaticum due to right ventricular [RV] failure: one of them is the FIB4 index. Another method, Fibroscan, is based on an ultrasound technique from elastography.

OBJECTIVE

to assess the correlation and determination indices between the FIB4 index and the assessment of liver stiffness by Fibroscan (E) on one hand and echocardiographic parameters describing RV function on the other hand. The study group: 33 patients (74 ± 13 years) with heart failure due to pulmonary hypertension, arterial hypertension, valvular diseases, myocardial infarction or cardiomyopathy.

RESULTS

echocardiography - RV dimension 38 ± 8 mm, systolic pressure in pulmonary artery (SPAP) 53 ± 24 mmHg, tricuspid annular plane systolic excursion (TAPSE) 17 ± 4mm, acceleration time of flow through the pulmonary valve (ACT) 79 ± 23 ms, the degree of tricuspid valve regurgitation 2 ± 1; the FIB4 result in this group - 2.54 ± 1.19, and the stiffness index E: 13.79 ± 12.55 kPa. Only RV dimension and the degree of tricuspid valve regurgitation showed moderately strong positive correlation with the stiffness index E: the correlation index - 0.327 and 0.382, respectively, with the determination index 27.9% and 43.4%, respectively.

CONCLUSION

The results emphasize the relationship between the morphological remodeling of the RV and the degree of secondary tricuspid regurgitation and the advancement of fibrotic changes in the liver and encourage the continuation of studies on larger groups of patients with a homogeneous etiology of RV failure, using a wider spectrum of echocardiographic parameters.