Hepatic function in acute heart failure

Authors

Keywords:

acute heart failure, liver function tests, complications.

Abstract

Introduction: A frequently underestimated aspect in patients with heart failure is liver function.

Objective: To establish the relationship between alterations in liver function tests and the evolution and prognosis of patients with acute heart failure.

Methods: Cross-sectional descriptive research in patients hospitalized with acute heart failure in the Cardiology Ward of the "General Calixto García" University Hospital from October 2020 to July 2021. The sample consisted of 149 patients. All of them underwent echocardiography and hepatic profile, whose information was recorded in a data collection form. To meet the objective, statistical processing of the variables was performed; the significant variables were included in a multivariate study with logistic regression whose response variable was the presence of complications, the odds ratio was obtained for each increase in one unit of the independent variable; as well as the 95% confidence interval.

Results: The hepatic profile showed altered values in complicated patients with significant differences with respect to non-complicated patients. Multivariate analysis showed that each increase in one unit of aspartate aminotransferase and alkaline phosphatase was associated with an increase in the risk of complications of 8% and 6%, respectively.

Conclusions: Complicated patients have higher prevalence and severity of liver function alterations and aspartate aminotransferase and alkaline phosphatase are identified as predictors of unfavorable evolution and worse prognosis.

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Author Biography

Esther Leal Balón, Hospital Universitario General Calixto Garcia Iñiguez

Especialista en Cardiología, departamento de Arritmia y marcapasos, Servicio de Cardiología,Hospital Universitario General Calixto Garcia Iñiguez

References

Jennings LR, Connell C. How to Manage Heart Failure: New Guidelines 2018. Heart Lung Circ. 2018 [acceso 12/09/2021];27(11):1267-9. Disponible en: https://www.heartlungcirc.org/article/S1443-9506(18)31873-0/pdf

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics Update AHA 2019. Circulation. 2019 [acceso 12/09/2021];139(10):56-528. Disponible en: https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000659

Lupón J, Bayés Genís A. Mortalidad y reingresos por insuficiencia cardíaca: la necesidad de un registro oficial completo, abierto y homologable. Rev Esp Cardio. 2019 [acceso 20/06/2021];72(12):988-90. Disponible en: https://www.revespcardiol.org/es-mortalidad-reingresos-por-insuficiencia-cardiacaarticulo-S0300893219302027

Sicras Mainar A, Sicras Navarro A, Palacios B, Varela L, Delgado JF. Epidemiología y tratamiento de la insuficiencia cardiaca en España: estudio PATHWAYS-HF. Rev Esp Cardio.2022 [acceso 20/04/2022];75(1):31-8. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0300893220305467

Trullàs JC, Pérez Calvo JI, Conde Martel A, Llácer Iborra P, Suárez Pedreira I, Llanos Soler R, et al. Epidemiología de la insuficiencia cardíaca con fracción de eyección preservada: resultados del Registro RICA. Medicina Clínica. 2021 [acceso 20/06/2021];157(1):1-9. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0025775320305662

Anuario Estadístico de Salud de Cuba 2021. Ministerio de Salud Pública. Dirección de registros médicos y estadísticas de salud 2021. [acceso: 21/11/2022]. Disponible en: http://bvscuba.sld.cu/anuario-estadistico-de-cuba/

Javaloyes P, Miro O, Gil V, Martin Sánchez FJ, Jacob J, Herrero P, et al. ICA-SEMES Research Group. Clinical phenotypes of acute heart failure based on signs and symptoms of perfusion and congestion at emergency department presentation and their relationship with patient management and outcomes. Eur J Heart Fail. 2019 [acceso 25/10/2021];21:1353-65. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.1502

McMurray JJ, Packer M, Desai AS. Angiotensin-neprilysin inhibition versus enalapril in heart failure. The PARADIGM-HF Investigators and Committees. Eur J Heart Fail. 2014 [acceso 05/11/2021];16:817-25. Disponible en: https://www.nejm.org/doi/pdf/10.1056/NEJMoa1409077

Suzuki K, Claggett B, Minamisawa M, Packer M, Zile MR, Rouleau J, et al. Liver function and prognosis, and influence of sacubitril/valsartan in patients with heart failure with reduced ejection fraction. Eur J Heart Fail. 2020 [acceso 05/11/2021];22(9):1662-71. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.1853

Miró O, López Díez MP, Llorens P, Mir M, López Grima ML, Alonso H, Gil V, et al. Frecuencia, perfil y resultados de los pacientes con insuficiencia cardíaca aguda que ingresan directamente en hospitalización a domicilio desde urgencias. Rev Clin Española. 2021 [acceso 20/03/2022];221(1):1-8. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0014256520301417

Fraga González MC, Cid Conde L, Alves Pérez T, Martín Godínez C, Alonso Álvarez P, López Castro J. Perfil clínico-epidemiológico del paciente con insuficiencia cardíaca en un hospital universitario. Metas de enfermería. 2019 [acceso 23/03/2022]; 22(4):65-70. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=6898049

Baialardo AG. Síndrome cardiohepático. ¿Qué debemos saber cómo cardiólogos? Insuf Card. 2015 [acceso 05/11/2021];10(2): 66-77. Disponible en: http://www.redalyc.org/articulo.oa?id=321941095003

Fairman EB, Mauro VM, Charask AA, Castillo Costa YB, Marrodán SE, Spampinato EG, et al. Significado clínico de las alteraciones en las pruebas de función hepática en la insuficiencia cardíaca descompensada. Rev Argent Cardiol. 2017 [acceso 05/11/2021];85:216-22 [acceso 05/11/2021]. Disponible en: http://www.scielo.org.ar/pdf/rac/v85n3/v85n3a06.pdf

Vega Candelario R. Cirrosis hepática cardíaca con diez años de evolución; sin causa etiológica conocida; en el Siglo XXI. Rev Cuban Cardiol. 2019 [acceso 05/11/2021];25(1). Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7162471

Tremont G. Hiperbilirrubinemia. Gen. 2009 [acceso 23/04/22];63(2):127-9. Disponible en: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0016-35032009000200014&lng=es

Arana Ruiz, EM. Hiperbilirrubinemia como factor pronóstico de mortalidad intrahospitalaria en pacientes con insuficiencia cardiaca congestiva descompensada en el Hospital Belén de Trujillo (Trabajo académico de Segunda Especialidad). Universidad Nacional de Trujillo. Repositorio institucional de tesis de grado y posgrado. 2018 [acceso 23/04/22]. Disponible en: https://dspace.unitru.edu.pe/bitstream/handle/UNITRU/16177/AranaRuiz_E.pdf?se quence=3&isAllowed=y

Samsky MD, Dunning A, DeVore AD, Schulte PJ, Starling RC, Wilson Tang WH, et al. Liver function tests in patients with acute heart failure and associated outcomes: insights from ASCEND-HF. Eur J Heart Fail. 2016 [acceso 25/10/2021];18(4):424-32. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26707029/

Ziwei Chen, Jing He, Chu Chen, Qi Lu. Association of Total Bilirubin with All Cause and Cardiovascular Mortality in the General Population. Front Cardiovasc Med. 2021 [acceso 25/10/2021];8:670768. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34222369/

Knoll Koehne A, Lefkowitch JH. Heart Disease and the Liver: Pathologic Evaluation. Gastroenterol Clin North Am. 2017 [acceso 25/10/2021];46(2):421-35. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28506373/

Vyskocilova K, Spinarova L, Spinar J, Mikusova T, Vitovec J, Malek J, et al. Prevalence and clinical significance of liver function abnormalities in patients with acute heart failure. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015 [acceso 25/10/2021];159(3):429-36.. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24622040/

Hiroshi Miyama, Yasuyuki Shiraishi, Shun Kohsaka, Ayumi Goda, Yosuke Nishihata, Yuji Nagatomo, et al. Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure. J Clin Med. 2021 [acceso 05/11/2021];10(8):1730. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33923618/

Nikolaou M, Parissis J, Yilmaz MB, Seronde MF, Kivikko M, Laribi S, et al. Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure. Eur Heart J. 2013 [acceso 25/10/2021];34(10):742-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/23091203/

Weihao Liang, Xin He, Dexi Wu, Ruicong Xue, Bin Dong, Marvin Owusu-Agyeman, et al. Prognostic Implication of Liver Function Tests in Heart Failure with Preserved Ejection Fraction without Chronic Hepatic Diseases: Insight From TOPCAT Trial. Front Cardiovasc Med. 2021 [acceso 25/10/2021];8:618816. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34055924/

-Mene Afejuku TO, Moisa EA, Akinlonu A, Dumancas C, Veranyan S, Pérez JA, et al. The relevance of serum albumin among elderly patients with acute decompensated heart failure. J Geriatr Cardiol. 2019 [acceso 13/06/2022];16(7):522-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31447891/

Shoichiro Y, Takatoshi K, Hiroki M, Jun S, Megumi S, Azusa M, et al. Relationship between Hypoalbuminemia on Admission and Long-term Mortality in Patients with Acute Decompensated Heart Failure. Intern Med. 2019 [acceso 13/06/2022];58(12):16951702. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30799337/

El Iskandarani M, El Kurdi B, Murtaza G, Paul TK, Refaat MM. Prognostic role of albumin level in heart failure: A systematic review and meta-analysis. Medicine (Baltimore). 2021 [acceso 13/06/22];100(10):e24785. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33725833/

Biegus J, Hillege HL, Postmus D, Valente MAE, Bloomfield D, Cleland JGF, et al. Abnormal liver function tests in acute heart failure: relationship with clinical characteristics and outcome in the PROTECT study. Eur J Heart Fail. 2016 [acceso 13/06/22];18(7):830-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27170455/

Published

2023-04-05

How to Cite

1.
Peña Céspedes IM, Leal Balón E, Arjona Rodríguez IA, Sobrado Iribar Y, Ramos Rojas R, Fernández Massip H. Hepatic function in acute heart failure. Rev. cuba. cardiol. cir. cardiovasc. [Internet]. 2023 Apr. 5 [cited 2025 Mar. 10];29(2):e1457. Available from: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/1457

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Original Articles