Determinants of increased serum markers of liver fibrosis in patients with chronic heart failure

Abstract

Aim. To study the factors associated with an increase in surrogate serum markers of liver fibrosis in patients with chronic heart failure (CHF). Materials and methods. The study included 100 patients with CHF. All patients underwent echocardiography on a Samsung Medison EKO7 ultrasound scanner. The following liver fibrosis indices were determined: Forns index, FIB-4, Lok index, BARD, NAFLD Fibrosis Score (NFS). Results. According to the results of the correlation analysis, positive correlations were found between the NFS values and the thickness of the anterior wall of the right ventricle (RV) (r=0.218; p=0.036) and the inverse between the NFS values and the TAPSE value (r= -0.214; p=0.045). Lok index values directly correlated with the volume of the left atrium (r=0.220; p=0.035) and systolic pressure in the pulmonary artery (SPAP) (r=0.251; p=0.026). In addition, an increase in SPAP was also associated with an increase in the Forns index (r=0.395; p=0.0001) and FIB-4 (r=0.223; p=0.047). According to the results of a polynomial logistic regression analysis, the Forns index increase predictors of more than 75 percentile were an increase in the SPAP ≥50 mm Hg and hydrothorax; NFS - increase in SPAP ≥50 mmHg and the end-diastolic size of the RV> 4.2 cm; Lok index - an increase in SPAP ≥50 mm Hg, end-diastolic size of the RV > 4.2 cm and a decrease in TAPSE <17 mm. Conclusion. In patients with CHF, the presence of dilatation of the right ventricle, pulmonary hypertension, and reduction in contractility of the right ventricle are the main determinants of the increase in non-invasive serum indices of liver fibrosis.