Prognostic value of liver shear wave elastography after transcatheter aortic valve implantation in severe aortic...

Shear wave elastography (SWE) is a noninvasive ultrasound technique that quantifies liver stiffness. Previous studies have suggested that liver SWE can serve as an indirect marker of hepatic congestion. However, it remains unclear whether liver SWE measured after transcatheter aortic valve implantation (TAVI) is associated with clinical outcomes.

A total of 127 consecutive patients with severe aortic stenosis who underwent TAVI and had liver SWE measured using abdominal ultrasonography at discharge were enrolled. Liver SWE was obtained from the right hepatic lobe via an intercostal approach. Patients were stratified by the median liver SWE value (1.36 m/s): low-SWE group (< 1.36 m/s; n = 59) and high-SWE group (≥ 1.36 m/s; n = 68). The primary endpoint was a composite of all-cause death and heart failure (HF) rehospitalization.

All 127 patients were followed for 24 months, during which 21 (16.5 %) experienced the primary endpoint. Kaplan-Meier analysis showed a higher cumulative incidence of the primary endpoint in the high-SWE group than in the low-SWE group (log-rank P = 0.019). In Cox proportional hazards models adjusted using inverse probability of treatment weighting, high liver SWE was independently associated with an increased risk of the primary endpoint (hazard ratio 3.66; 95 % confidence interval 1.30-10.32; P = 0.014).

High liver SWE after TAVI was independently associated with an increased 24-month risk of all-cause death and HF rehospitalization.