title: Liver stiffness measurements for evaluation of central venous pressure in congenital heart diseases.
abstract: OBJECTIVE
  Transient elastography (TE; Fibroscan, Echosens, France) is a non-invasive and reproducible approach to assess liver stiffness (LS). LS has been reported to be associated with fibrosis but central venous pressure (CVP) can also influence LS values. We sought to evaluate the correlation between LS and CVP in a large cohort of children and adults with congenital heart disease.
  
  
  METHODS
  All patients referred in our institution between 2012 and 2013 for diagnostic or interventional right heart catheterisation (RHC) were prospectively enrolled excluding patients with acute heart failure, chronic alcohol abuse, chronic liver disease, severe obesity and ascites. Patients underwent LS measurement and CVP measurement by RHC under general anaesthesia within the same or subsequent day.
  
  
  RESULTS
  Sixty children (7.4±5.5 years) and 36 adults (38±16 years) were included. Median CVP was 6 mm Hg (range 3-15), median LS was 5 kPa (range 2.8-47.2). LS significantly correlated with CVP (r=0.75, p<10(-4)). In the two subgroups (ie, children and adults), correlation was r=0.68 and r=0.84 (p<10(-4)), respectively. In the overall population, the area under the curve of LS for identification of CVP >10 mm Hg was 0.972 (95% CI 0.855 to 1; p<0.05). Optimal cut-off value of LS for detection of CVP >10 mm Hg was 8.8 kPa (sensitivity=91.67%, specificity=96.25%).
  
  
  CONCLUSIONS
  LS measurement using TE is a rapid and reliable method to evaluate CVP in patients with congenital heart disease.
authors.affiliation: Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France.
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Jalal
authors.affiliation: Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Iriart
authors.affiliation: Department of Hepatology and Gastroenterology, University Hospital of Bordeaux, Pessac, France INSERM 1053, Université Bordeaux, Bordeaux, France.
authors.forename: Victor
authors.initials: V
authors.lastname: De Lédinghen
authors.affiliation: Rheumatology Department, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Barnetche
authors.affiliation: INSERM 1053, Université Bordeaux, Bordeaux, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Hiriart
authors.affiliation: INSERM 1053, Université Bordeaux, Bordeaux, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Vergniol
authors.affiliation: INSERM 1053, Université Bordeaux, Bordeaux, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Foucher
authors.affiliation: Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France INSERM 1053, Université Bordeaux, Bordeaux, France.
authors.forename: Jean-Benoit
authors.initials: JB
authors.lastname: Thambo
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods; D002496:Central Venous Pressure; D002648:Child; D002675:Child, Preschool; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005602:France; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013223:Statistics as Topic