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Liver stiffness measurements for evaluation of central venous pressure in congenital heart diseases
  1. Zakaria Jalal1,
  2. Xavier Iriart1,
  3. Victor De Lédinghen2,3,
  4. Thomas Barnetche4,
  5. Jean-Baptiste Hiriart3,
  6. Julien Vergniol3,
  7. Juliette Foucher3,
  8. Jean-Benoit Thambo1,3
  1. 1Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France
  2. 2Department of Hepatology and Gastroenterology, University Hospital of Bordeaux, Pessac, France
  3. 3INSERM 1053, Université Bordeaux, Bordeaux, France
  4. 4Rheumatology Department, University Hospital of Bordeaux, Bordeaux, France
  1. Correspondence to Dr Zakaria Jalal, Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Avenue Magellan, Pessac 33600, France; jalalzakaria1{at}gmail.com

Abstract

Objective Transient elastography (TE; Fibroscan, Echosens, France) is a non-invasive and reproducible approach to assess liver stiffness (LS). LS has been reported to be associated with fibrosis but central venous pressure (CVP) can also influence LS values. We sought to evaluate the correlation between LS and CVP in a large cohort of children and adults with congenital heart disease.

Methods All patients referred in our institution between 2012 and 2013 for diagnostic or interventional right heart catheterisation (RHC) were prospectively enrolled excluding patients with acute heart failure, chronic alcohol abuse, chronic liver disease, severe obesity and ascites. Patients underwent LS measurement and CVP measurement by RHC under general anaesthesia within the same or subsequent day.

Results Sixty children (7.4±5.5 years) and 36 adults (38±16 years) were included. Median CVP was 6 mm Hg (range 3–15), median LS was 5 kPa (range 2.8–47.2). LS significantly correlated with CVP (r=0.75, p<10−4). In the two subgroups (ie, children and adults), correlation was r=0.68 and r=0.84 (p<10−4), respectively. In the overall population, the area under the curve of LS for identification of CVP >10 mm Hg was 0.972 (95% CI 0.855 to 1; p<0.05). Optimal cut-off value of LS for detection of CVP >10 mm Hg was 8.8 kPa (sensitivity=91.67%, specificity=96.25%).

Conclusions LS measurement using TE is a rapid and reliable method to evaluate CVP in patients with congenital heart disease.

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