Photo Credit: Pavel Muravev

The following is a summary of “Association Between the Liver Fibrosis Markers and Scores, and Hemodynamic Congestion Assessed by Peripheral Venous Pressure in Patients With Acute Heart Failure,” published in the November 2023 issue of Cardiology by Nagao et al.

In patients with acute heart failure (HF), assessing congestion remains crucial. Peripheral venous pressure (PVP) is an established surrogate for right atrial pressure in evaluating congestion. Simultaneously, liver fibrosis markers are emerging as indicators of organ injury in acute HF. This study delved into the correlation between liver fibrosis markers and PVP in acute HF.

The research involved 229 acute HF patients, analyzing liver fibrosis markers, such as the 7S domain of collagen type IV N-terminal propeptide (P4NP 7S), aspartate aminotransferase-to-platelet ratio index, fibrosis-4, and nonalcoholic fatty liver disease fibrosis score, alongside PVP measurements before discharge. Of these markers, P4NP 7S exhibited the strongest correlation with PVP (Pearson r=0.40). Patients with elevated P4NP 7S levels (≥median [6.2 ng/mL]) faced a higher risk of cardiovascular death or HF hospitalization (adjusted hazard ratio [HR], 1.80 [95% CI, 1.09–3.04], P=0.02). The group experiencing concurrent high PVP (≥mean [8 mm Hg]) and high P4NP 7S displayed a significant risk relative to other groups for cardiovascular death or HF hospitalization (adjusted HR, 2.63 [95% CI, 1.43–5.05], P=0.002). Moreover, a persistent elevation in PVP for one month post-discharge correlated with a sustained increase in P4NP 7S levels.

In conclusion, the study established a notable association between the liver fibrosis marker P4NP 7S and congestion assessment via PVP in acute HF patients. These findings suggest that PVP and P4NP 7S could be vital tools for evaluating congestion-related organ damage and predicting outcomes in acute HF.

Source: ahajournals.org/doi/10.1161/JAHA.123.030788