Background The prevalence and prognostic value of liver function abnormalities in patients with chronic systolic heart failure (HF) have not been systematically evaluated.
Methods and results 16 681 in-hospital patients from 12 hospital of Hubei province, China, with diagnosis of chronic systolic HF and LVEF<50% were enrolled. All patients were followed up by telephone contact. Patients were divided into death and survival groups according to the result of follow-up. Over media 3 years follow-up, 6453 (38.69%) patients died. The prevalence of liver function abnormality was 71.94% (12001/16681). The elevations of direct bilirubin, γ-glutamyl- transferase and alanine aminotransferase were the most common which accounts 33.37% (4863/14574), 32.51% (4337/13341) and 30.12% (5024/16681), respectively. The abnormality of alkaline phosphatase was less, the elevation and declination of which accounts 3.82% (474/12397) and 4.51% (559/12397) respectively. The prevalence of low albumin and total bilirubin elevation was 23.24% (3408/14664) and 19.37% (3231/16681). Low albumin (HR 0.411, 95% CI 0.225 to 0.752; p=0.004) and elevated direct bilirubin (HR 1.785, 95% CI 1.625 to 1.986; p=0.037), total bilirubin (HR 1.358, 95% CI 1.034 to 1.783; p=0.028) were determinated as the independent risk factors of total mortality. Study revealed correlations of LVEF with direct bilirubin (r=−0.235, p<0.0001), total bilirubin (r=−0.209, p<0.0001), albumin (r=0.107, p<0.0001) and right ventricular end-diastolic diameter (RVDD) with direct bilirubin (r=0.149, p<0.0001), total bilirubin (r=0.154, p<0.0001), albumin (r=−0.086, p<0.0001).