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Open AccessArticle

Right Ventricular Free Wall Strain and Congestive Hepatopathy in Patients with Acute Worsening of Chronic Heart Failure: A CATSTAT-HF Echo Substudy

1
Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
2
Institute of Emergency Medicine of Split-Dalmatia County, Spinciceva 1, 21000 Split, Croatia
3
Clinic for Cardiovascular Diseases, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia
4
Department of Internal Medicine, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
5
Department of Medical Laboratory Diagnostics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia
6
Department of Health Studies, University of Split, Rudjera Boskovica 35 P.P. 464, 21000 Split, Croatia
7
Department of Cardiovascular and Thoracic Sciences, IRCCS Fondazione Policlinico A. Gemelli, Università Cattolica Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1317; https://doi.org/10.3390/jcm9051317
Received: 14 April 2020 / Revised: 25 April 2020 / Accepted: 27 April 2020 / Published: 2 May 2020
(This article belongs to the Section Cardiology)
Right ventricular (RV) function is an important predictor of prognosis in patients with heart failure. However, the relationship of the RV free wall longitudinal strain (RV FWS) and the degree of hepatic dysfunction during the acute worsening of heart failure (AWHF) is unknown. We sought to determine associations of RV FWS with laboratory liver function tests and parameters of RV function including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RV FAC), maximal tricuspid jet velocity (TR Vmax), RV S′ velocity, and estimated RV systolic pressure (RVSP). A total of 42 AWHF patients from the CATSTAT-HF study were stratified in two groups by the RV FWS median (−16.5%). Patients < RV FWS median had significantly prolonged international normalized ratio (INR; p = 0.002), increased total bilirubin (p < 0.001) and alkaline phosphatase (ALP; p = 0.020), and decreased albumin (p = 0.005) and thrombocytes (p = 0.017) compared to patients > RV FWS median. RV FWS independently correlated to total bilirubin (β = 0.457, p = 0.004), ALP (β = 0.556, p = 0.002), INR (β = 0.392, p = 0.022), albumin (β = −0.437, p = 0.013), and thrombocytes (β = −404, p = 0.038). Similarly, TAPSE, RV FAC, and RV S′ significantly correlated with RV FWS. In conclusion, RV impairment, reflected in reduced RV FWS, is independently associated with a higher degree of hepatic dysfunction among patients with AWHF (CATSTAT-HF ClinicalTrials gov number, NCT03389386). View Full-Text
Keywords: echocardiography; heart failure; heart failure decompensation; hepatic insufficiency; laboratory markers; liver dysfunction; ventricular dysfunction; right echocardiography; heart failure; heart failure decompensation; hepatic insufficiency; laboratory markers; liver dysfunction; ventricular dysfunction; right
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MDPI and ACS Style

Borovac, J.A.; Glavas, D.; Susilovic Grabovac, Z.; Supe Domic, D.; Stanisic, L.; D’Amario, D.; Duplancic, D.; Bozic, J. Right Ventricular Free Wall Strain and Congestive Hepatopathy in Patients with Acute Worsening of Chronic Heart Failure: A CATSTAT-HF Echo Substudy. J. Clin. Med. 2020, 9, 1317.

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