title: Abnormal liver function in relation to hemodynamic profile in heart failure patients.
abstract: BACKGROUND
  We studied the relation between liver function abnormalities and hemodynamic profile in patients with heart failure (HF).
  
  
  RESULTS
  In 323 HF patients, liver function was determined by aspartate and alanine aminotransferase (AST, ALT), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), lactate dehydrogenase, and direct and total bilirubin (Bili dir, Bili tot). Central venous pressure (CVP) and cardiac index (CI) were determined invasively. Follow-up consisted of time to all-cause mortality. Mean age was 53 +/- 15 years, and 60% were male. In multivariable analysis, all liver function tests related to CVP, but higher CVP was predominantly related to GGT (r = 0.336, P < .001) and Bili dir (r = 0.370, P < .001). Only elevated AST (r =-0.177, P < .01), ALT (r = -0.130, P < .05), and Bili tot (r = -0.158, P < .01) were associated with both low CI and elevated CVP. The prognostic value of abnormal liver function tests was related to their interaction with CI and CVP.
  
  
  CONCLUSIONS
  Elevated liver function tests mainly indicate higher CVP, whereas only the presence of elevated AST, ALT, or Bili dir may indicate a low CI. The absence of prognostic information in the presence of invasive hemodynamic measurements suggests that abnormal liver function tests in HF reflect a poor hemodynamic status.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: V M
authors.initials: VM
authors.lastname: van Deursen
authors.forename: K
authors.initials: K
authors.lastname: Damman
authors.forename: H L
authors.initials: HL
authors.lastname: Hillege
authors.forename: A P
authors.initials: AP
authors.lastname: van Beek
authors.forename: D J
authors.initials: DJ
authors.lastname: van Veldhuisen
authors.forename: A A
authors.initials: AA
authors.lastname: Voors
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D008111:Liver Function Tests / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies