Impact of hepatopathy on the prognosis of heart failure in 2600 patients

Propose To study an association between hepatic and cardiac function at patients with chronic heart failure (CHF). Methods Overall, 2600 patients from 22 to 58 years are included. CHF has been caused by ischemic (45%) and idiopathic dilated cardiomyopathies (DC 35%). Echocardioscopy and biochemistry (aspartate (AsT) and alanine transaminase (AlT), total bilirubin (TB) measuring) were made. After initial investigation, all patients are divided on two: I (with liver abnormalities, 30% with average age 43.7 ± 2.1 years) and II (without hepatopathy, 70%, with average age 41.4 ± 1.9 years) groups. Results The analysis of diseases severity showed that differences of NYHA class was comparable (3.1 ± 0.4 vs. 2.9 ± 0.6, P  = 0.05), but I gr pts characterized by prevalence of right ventricle insufficiency: oedema, hepathomegaly, swollen jugular veins. The echocardioscopy results shown that I group pts were characterized rather by the worst LV function (LV ESV −188.2 ± 8.4 mm 3 vs. 159.4 ± 9.2 mm 3 accordingly, P  = 0.04 and LV EF −36.8 ± 2.2% vs 42.7 ± 1.6%, P  = 0.03). The given changes were accompanied by increasing of right ventricle diameter at I gr pts on 15.8% (4.4 ± 0.15 mm vs. 3.8 ± 0.18, P  = 0.03) and RV EF decreasing on 6.4% (42.8 ± 2.1% vs 49.2 ± 1.9%, P  = 0.04). The revealed feature of patients with liver dysfunction also was tricuspid regurgitation of various degrees, registered on 25% more versus II gr patients ( P  = 0.000). Conclusion The 37.2% pts with various etiology CHF had signs of hepatic dysfunction. Hepatic tests abnormalities associated with right ventricle insufficiency symptoms increasing and worsening of left and right heart function.