Yoshitani Takashi, Asakawa Naoya, Sakakibara Mamoru, Noguchi Keiji, Tokuda Yusuke, Kamiya Kiwamu, Iwano Hiroyuki, Yamada Satoshi, Kudou Yusuke, Nishida Mutsumi, Shimizu Chikara, Amano Toraji, Tsutsui Hiroyuki
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.
Circ J. 2016 Apr 25;80(5):1187-95. doi: 10.1253/circj.CJ-15-1200. Epub 2016 Mar 30.
Heart failure (HF) causes organ congestion, which is thought to increase organ stiffness. The virtual touch quantification (VTQ) method can be used to assess liver stiffness in patients with chronic liver diseases. This study aimed to measure liver and kidney stiffness using VTQ and to determine its value for assessing organ congestion in patients with HF.
This study included 10 normal subjects and 38 HF patients (age 52.3±16.7 years, left ventricular ejection fraction 27.0±9.4%, plasma B-type natriuretic peptide [BNP] 1,297.3±1,155.1 pg/ml). We investigated the relationships between clinical characteristics and hemodynamics and liver and kidney stiffness, and assessed the effects of medical treatment on these measurements. Liver stiffness was significantly higher in HF patients (1.17±0.13 m/s vs. 2.03±0.91 m/s, P=0.004) compared with normal subjects, but kidney stiffness was similar in both groups. Central venous pressure (CVP) (P=0.021) and BNP (P=0.025) were independent predictive factors for increased liver stiffness in HF patients. Liver stiffness decreased significantly from 2.37±1.09 to 1.27±0.33 m/s (P<0.001) after treatment. Changes in liver stiffness in HF patients significantly correlated with changes in CVP (R=0.636, P=0.014) and cardiac index (R=-0.557, P=0.039) according to univariate analysis, and with changes in CVP in multivariate analysis.
Liver stiffness measured by noninvasive VTQ methods can be used to assess liver congestion and therapeutic effects in patients with HF. (Circ J 2016; 80: 1187-1195).
心力衰竭（HF）会导致器官淤血，人们认为这会增加器官硬度。虚拟触诊定量（VTQ）方法可用于评估慢性肝病患者的肝脏硬度。本研究旨在使用VTQ测量肝脏和肾脏硬度，并确定其在评估HF患者器官淤血方面的价值。
本研究纳入了10名正常受试者和38名HF患者（年龄52.3±16.7岁，左心室射血分数27.0±9.4%，血浆B型利钠肽[BNP]1297.3±1155.1 pg/ml）。我们研究了临床特征、血流动力学与肝脏和肾脏硬度之间的关系，并评估了药物治疗对这些测量值的影响。与正常受试者相比，HF患者的肝脏硬度显著更高（1.17±0.13 m/s对2.03±0.91 m/s，P = 0.004），但两组的肾脏硬度相似。中心静脉压（CVP）（P = 0.021）和BNP（P = 0.025）是HF患者肝脏硬度增加的独立预测因素。治疗后肝脏硬度从2.37±1.09显著降低至1.27±0.33 m/s（P < 0.001）。根据单因素分析，HF患者肝脏硬度的变化与CVP的变化显著相关（R = 0.636，P = 0.014）和心脏指数的变化（R = -0.557，P = 0.039），在多因素分析中与CVP的变化相关。
通过非侵入性VTQ方法测量的肝脏硬度可用于评估HF患者的肝脏淤血和治疗效果。（《循环杂志》2016年；80：1187 - 1195）
