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Abnormal liver function in relation to hemodynamic profile in heart failure patients
V M van Deursen1, K Damman, H L Hillege
1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Journal of Cardiac Failure
|February 4, 2010
Summary
Abnormal liver function tests in heart failure (HF) patients primarily indicate elevated central venous pressure (CVP). Specific tests like AST, ALT, and total bilirubin may also signal low cardiac index (CI), reflecting poor hemodynamic status.
Area of Science:
- Cardiology
- Hepatology
- Internal Medicine
Background:
- Heart failure (HF) is often associated with secondary organ dysfunction.
- Liver function abnormalities are common in HF patients and may reflect disease severity.
Purpose of the Study:
- To investigate the relationship between liver function test (LFT) abnormalities and hemodynamic parameters in patients with heart failure.
- To determine the prognostic value of LFTs in relation to central venous pressure (CVP) and cardiac index (CI).
Main Methods:
- Studied 323 heart failure patients.
- Assessed liver function using AST, ALT, alkaline phosphatase, GGT, LDH, and bilirubin.
- Measured CVP and CI invasively; followed patients for all-cause mortality.
Main Results:
- All LFTs correlated with CVP; GGT and direct bilirubin showed the strongest association with higher CVP.
- Elevated AST, ALT, and total bilirubin were linked to both low CI and elevated CVP.
- Prognostic value of LFTs depended on their interaction with CI and CVP.
Conclusions:
- Elevated LFTs in HF mainly reflect increased CVP.
- Specific LFTs (AST, ALT, direct bilirubin) may indicate a low CI.
- Abnormal LFTs in HF signify a compromised hemodynamic status, especially when invasive measurements are available.
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