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Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts

Satoshi Abe1, Akiomi Yoshihisa2, Mai Takiguchi1

  • 1Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan.

Plos One
|June 24, 2014
PubMed

Insights

The Model for End-Stage Liver Disease excluding INR (MELD-XI) score predicts mortality in heart failure (HF) patients. A higher MELD-XI score indicates increased risk of cardiac death and overall mortality in HF.

Area of Science:

  • Cardiology
  • Hepatology
  • Prognostic Biomarkers

Background:

  • Liver dysfunction, known as congestive hepatopathy, is a complication of heart failure (HF).
  • The Model for End-Stage Liver Disease excluding INR (MELD-XI) score assesses liver function and predicts outcomes in advanced HF patients.
  • The prognostic value of MELD-XI in the general HF population is not well-established.

Purpose of the Study:

  • To investigate the impact of the MELD-XI score on the prognosis of patients with decompensated heart failure.
  • To determine if MELD-XI can predict mortality and identify HF patients at higher risk.

Main Methods:

  • Retrospective analysis of 562 patients admitted for decompensated HF.
  • Patients were stratified into two groups based on the median MELD-XI score (Group L: <10, Group H: ≥10).
  • Comparison of all-cause mortality, cardiac mortality, and echocardiographic parameters between groups.

Main Results:

  • A higher MELD-XI score (≥10) was associated with significantly higher rates of all-cause mortality, cardiac death, and non-cardiac death.
  • MELD-XI independently predicted cardiac deaths and all-cause mortality in HF patients.
  • Patients with higher MELD-XI scores exhibited increased right atrial/ventricular areas, inferior vena cava diameter, and pulmonary artery systolic pressure.

Conclusions:

  • The MELD-XI score serves as a valuable prognostic tool in heart failure.
  • Elevated MELD-XI identifies HF patients at increased risk, characterized by right heart volume overload and pulmonary hypertension.
  • MELD-XI may indicate the presence of multi-organ dysfunction in heart failure patients.
Abstract

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