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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Related Experiment Video

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Association Between Liver Dysfunction Markers and Mortality in Heart Failure: A Systematic Review and Meta-Analysis.

Ali Salman1, Ali Irshad2, Hamza I Chughtai3

  • 1Department of Internal Medicine, Warrington Hospital, Warrington, GBR.

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|May 6, 2026
PubMed
Summary

Elevated liver dysfunction markers, including Model for End-Stage Liver Disease (MELD) and MELD excluding international normalized ratio (MELD-XI) scores, are linked to higher mortality risk in heart failure (HF) patients. These markers aid in risk stratification for HF populations.

Keywords:
all-cause mortalityheart failureliver dysfunctionmeld scoremeld-xi

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Area of Science:

  • Cardiology
  • Hepatology
  • Clinical Epidemiology

Background:

  • Heart failure (HF) is a global health concern associated with significant morbidity and mortality.
  • Cardiac dysfunction can lead to liver injury, termed cardiohepatic syndrome, due to hepatic congestion and impaired perfusion.
  • Liver dysfunction markers are being explored as prognostic indicators in HF.

Purpose of the Study:

  • To systematically review and meta-analyze the association between liver dysfunction markers (MELD and MELD-XI) and mortality outcomes in adult HF patients.
  • To evaluate the prognostic value of these markers across different HF phenotypes.

Main Methods:

  • A systematic literature search was performed to identify relevant studies.
  • Nine studies involving over 32,000 HF patients were included in the meta-analysis.
  • Hazard ratios (HRs) were pooled using a random-effects model, with subgroup analyses conducted by marker type and HF phenotype.

Main Results:

  • Elevated MELD or MELD-XI scores were significantly associated with increased all-cause mortality in HF patients (pooled HR = 1.12).
  • Significant associations were found for both MELD-XI (HR = 1.09) and MELD scores (HR = 1.10).
  • Associations persisted across acute, chronic, and advanced HF phenotypes.

Conclusions:

  • Liver dysfunction markers, specifically MELD and MELD-XI, are significant correlates of increased mortality in HF patients.
  • These markers provide valuable prognostic information and can aid in risk stratification within diverse HF populations.
  • Further research is warranted to integrate these markers into clinical decision-making for HF management.