title: Usefulness of transient elastography for noninvasive and reliable estimation of right-sided filling pressure in heart failure.
abstract: Accurate noninvasive assessment of right atrial pressure (RAP) is important for volume management in patients with heart failure (HF). Transient elastography is a noninvasive and reliable method to assess liver stiffness (LS). We investigated the value of LS for evaluation of RAP in patients with HF without structural liver disease. We measured LS using transient elastography (Fibroscan) in 31 patients undergoing right-sided cardiac catheterization (test group). The relation between LS and RAP found in the test group was used to derive the best-fit model to predict RAP. The applicability of the model was then tested in a validation group of 49 additional patients. There was an excellent correlation between LS and RAP in the test group (r = 0.95, p <0.0001; RAP = -5.8 + 6.7 × ln [LS]). Natural log transformation (ln) of LS provided the regression equation to predict RAP. When the equation model derived from the test group was applied to the validation group, predicted RAP correlated excellently with actual RAP (r = 0.90, p <0.0001). The receiver operating characteristic curve analyses in the test group showed that LS favorably compared with echocardiography for detecting RAP >10 mm Hg (area under the curve 0.958 vs 0.800, respectively, p = 0.047). In the validation group, LS with a cut-off value of 10.6 kPa for identifying RAP >10 mm Hg had a higher sensitivity and accuracy (p = 0.046 and p = 0.049, respectively) than echocardiography. In conclusion, LS may offer an accurate noninvasive diagnostic method to assess RAP in patients with HF.
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Tatsunori
authors: T
authors: Taniguchi
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: yasushisk@cardiology.med.osaka-u.ac.jp.
authors: Yasushi
authors: Y
authors: Sakata
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Tomohito
authors: T
authors: Ohtani
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Isamu
authors: I
authors: Mizote
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yasuharu
authors: Y
authors: Takeda
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yoshihiro
authors: Y
authors: Asano
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Masaharu
authors: M
authors: Masuda
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Hitoshi
authors: H
authors: Minamiguchi
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Machiko
authors: M
authors: Kanzaki
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yasuhiro
authors: Y
authors: Ichibori
authors: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Hiroyuki
authors: H
authors: Nishi
authors: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Koichi
authors: K
authors: Toda
authors: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yoshiki
authors: Y
authors: Sawa
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Issei
authors: I
authors: Komuro
mesh_terms: D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016278:Ventricular Function, Right / Q000502:physiology*; D017725:Ventricular Pressure / Q000502:physiology*