Liver Stiffness Measurement for Non-Invasive Assessment of Central Venous Pressure in Patients with Heart Failure: A Multicentre Pilot Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: AIMS: Central venous pressure (CVP) is an important variable in assessing heart failure (HF) patients. However, invasive CVP measurement using right heart catheterization is associated with potential complications, and accurate measurement requires careful attention to technique. In this multicentre pilot study, we aimed to evaluate whether non-invasively measured liver stiffness can be used to assess CVP in patients with HF. METHODS AND RESULTS: Patients aged 18 to 85 years with a history of HF (or left ventricular ejection fraction [LVEF] ≤40%) who required central venous line placement with CVP measurement were enrolled in an open-label study. Patients underwent simultaneous invasive catheter CVP measurement and non-invasive liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE). The primary endpoint was the agreement between CVP and LSM-derived CVP (-5.9 + 6.8 × ln[LSM]) in the supine position. Among the 38 patients who completed the study, 34 (89.5%) were male, the mean age was 63.8 years, and the median LVEF was 24.5%. CVP correlated with LSM-derived CVP (Spearman r = 0.53, p < 0.001). Bland-Altman analysis demonstrated a mean difference (measured CVP minus LSM-derived CVP) of 0.11 mmHg (95% confidence interval -1.31, 1.54). LSM identified clinically significant CVP elevation (>10 mmHg) with an area under the curve of 0.83. An LSM threshold >10 kPa yielded a sensitivity of 0.73 and a specificity of 0.78, correctly classifying CVP (>10 or ≤10 mmHg) in 76% of patients. CONCLUSIONS: Liver stiffness measurement is a promising non-invasive surrogate for CVP in patients with HF. Future studies are warranted to validate these findings and to assess the role of LSM for the screening, diagnosis, monitoring, and prognostic stratification of patients with HF.
DOI: 10.1002/ejhf.3722
Institutions: Inserm, Centre Hospitalier Régional et Universitaire de Nancy, Défaillance Cardiovasculaire Aiguë et Chronique, Université de Lorraine, Wroclaw Medical University, American Heart of Poland, Andrzej Frycz Modrzewski Krakow University, Carol Davila University of Medicine and Pharmacy, Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu", Echosens (France), Duke University, Duke Medical Center, University Medical Center Groningen, University of Groningen, Edward Hospital, Momentum Research, Université Paris Cité, Marqueurs cardiovasculaires en situation de stress
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,300
Funder: Echosens
OpenAlex ID: W4411352184