title: Value of Virtual Touch Quantification Elastography for Assessing Liver Congestion in Patients With Heart Failure.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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).
authors.affiliation: Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshitani
authors.forename: Naoya
authors.initials: N
authors.lastname: Asakawa
authors.forename: Mamoru
authors.initials: M
authors.lastname: Sakakibara
authors.forename: Keiji
authors.initials: K
authors.lastname: Noguchi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Kamiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iwano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kudou
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Nishida
authors.forename: Chikara
authors.initials: C
authors.lastname: Shimizu
authors.forename: Toraji
authors.initials: T
authors.lastname: Amano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsui
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002496:Central Venous Pressure / Q000502:physiology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood
chemical_list: D020097:Natriuretic Peptide, Brain