Author + information
- Fred Wu,
- Roshan Raza,
- Sarah Harney,
- Chinweike Ukomadu,
- Michael Landzberg,
- Anne Marie Valente,
- Roger Breitbart,
- Michael Singh,
- Alexander Opotowsky,
- Kimberlee Gauvreau and
- Maureen M. Jonas
Transient elastography (TE) offers a noninvasive correlate with the degree of hepatic fibrosis using the liver's viscoelastic properties. Factors other than fibrosis affect liver stiffness. We sought to determine whether hepatic congestion related to hemodynamics influences liver stiffness measurements (LSM) assessed by TE.
This was a prospective cohort study of subjects with Fontan circulation undergoing cardiac catheterization with or without liver biopsy. Subjects underwent TE within 5 days before the procedure. Clinical history, hemodynamic and biopsy data, and hepatic biomarkers were collected. Five subjects who previously underwent liver biopsy and TE were also included.
Data were collected on 50 subjects: 45 with hemodynamics, 10 with biopsy. Median age was 13.1y (range 2.4-57.8), and median time since Fontan was 9.9y (range 0.1-32.5). No subject had known hepatitis C. Mean LSM for the entire cohort was 21.4 ± 10.8 kPa. Univariate regression analysis using LSM as a continuous outcome variable is presented in Table 1. LSM is associated with more severe centrilobular fibrosis (p = 0.05). On multiple regression analysis, Fontan pressure (β = 0.901, p = 0.03) and cardiac index (β = −2.703, p = 0.02) were significant predictors of LSM with overall model R2 = 0.206.
Higher LSM is associated with unfavorable Fontan hemodynamics and advanced centrilobular hepatic fibrosis. TE may be a useful screening tool for identifying patients who warrant invasive testing.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Cardiology Solutions: Fontan Physiology in the Adult – Liver, Pregnancy and Survival
Abstract Category: 12. Congenital Cardiology Solutions: Adult
Presentation Number: 1117-117
- 2013 American College of Cardiology Foundation