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Abstract: TH-PO205

Liver Elasticity in Heart Failure Patient: The Role of Kidney in Cardio-Hepatic Interaction

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Sugawara, Hirohito, Showa Daigaku Yokohama-shi Hokubu Byoin, Yokohama, Kanagawa, Japan

Liver elastography is a novel ultrasound technique assessing elasticity of liver tissue. Previously, it had been reported that the more elevated liver stiffness, the poorer the prognosis in heart failure indicating cardio-hepatic interaction. However, clinical indication of liver elastography remains unrevealed. Moreover, reports about relationship between liver stiffness and heart failure subtypes haven’t well been published. Therefore, we have investigated the cardio-hepatic interaction using liver elastography in heart failure subtypes.


We prospectively enrolled 58 consecutive patients with heart failure admission from April 2022 to March 2023. Liver elastography, transthoracic echocardiography and blood sampling were done at the time of discharge from heart failure treatment.


Patients were divided into two groups according to the left ventricular ejection fraction (LVEF) of echocardiography: heart failure with reduced ejection fraction (HFrEF) group (EF ≦40%, n = 11) and non-HFrEF group (EF >40%, n = 31). The mean age of all patients was 83 ± 11 years. The mean age and the prevalence of hypertension and diabetes mellitus was higher in non-HFrEF group than in HFrEF group. The prevalence of taking SGLT2 inhibitors was lower in non-HFrEF group than in HFrEF group. LV end-diastolic diameter, LV end-systolic diameter was larger in HFrEF group than in non-HFrEF group. Tricuspid regurgitation pressure gradient (TRPG) was higher in non-HFrEF group than in HFrEF group. Inferior vena cava diameter was not different between two groups. The mean values of almost liver function tests of all patients were within the normal range. eGFR was lower in non-HFrEF group than in HFrEF group. Liver elasticity was higher in non-HFrEF group than in HFrEF group (7.1 ± 2.7 vs. 5.1 ± 1.5 hPa; P=0.008) indicating liver stiffness. Pearson’s correlation coefficient showed that liver elasticity was positively correlated with the prevalence of diabetes mellitus, LVEF, TRPG, serum creatinine, AST, GGT and was negatively correlated with LV end-diastolic diameter, LV end-systolic diameter.


Liver stiffness was elevated and renal function was decreased in EF-preserved heart failure patients. Liver elasticity was correlated with the parameter of congestion (TRPG) and useful for the assessment of congestion. Renal function was also correlated with liver elasticity.