PMID- 34945713
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211229
IS  - 2075-4426 (Print)
IS  - 2075-4426 (Electronic)
IS  - 2075-4426 (Linking)
VI  - 11
IP  - 12
DP  - 2021 Nov 23
TI  - The Cardio-Hepatic Relation in STEMI.
LID - 10.3390/jpm11121241 [doi]
LID - 1241
AB  - BACKGROUND: Hepatic injury secondary to congestive heart failure is well 
      described, however, only limited data exist about the possible impact of acute 
      cardiac dysfunction on the liver. We aimed to explore the possible cardio-hepatic 
      interaction in patients with myocardial infarction. MATERIAL AND METHODS: A 
      single-center retrospective cohort study of 1339 ST elevation myocardial 
      infarction (STEMI) patients who underwent primary coronary intervention between 
      June 2012 to June 2019. Echocardiographic examinations were performed to assess 
      left ventricular ejection fraction (LVEF) and central venous pressure (CVP). 
      Patients were stratified into four groups by their LVEF and CVP levels: LVEF >/= 
      45%, and CVP </= 10 mm/Hg (n = 853), LVEF < 45% with CVP </= 10 mm/Hg (n = 364), EF >/= 
      45%, with CVP > 10 mm/Hg (n = 61), and LVEF < 45% with CVP > 10 mm/Hg (n = 61). 
      Patients were evaluated for baseline and peak liver enzymes including alanine 
      transaminase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase 
      (GGT), alkaline phosphatase (ALP), and bilirubin. RESULTS: Greater severity of 
      cardiac dysfunction was associated with worse elevation of liver enzymes. We 
      found a graded increase in mean levels of maximal ALT, first and maximal ALP, and 
      first and maximal GGT values. Using propensity score matching to estimate the 
      impact of cardiac dysfunction on liver injury, we chose patients with the worst 
      cardiac function parameters: (LVEF < 45% and CVP >10 mm/Hg; n = 61) and compared 
      them to matched patients with better cardiac function (n = 45). We found a 
      significantly higher level of maximal ALT, first and maximal ALP, and GGT values 
      in the group with the worst cardiac function parameters (p < 0.05). CONCLUSIONS: 
      Among patients with STEMI, the combination of decreased LVEF and venous 
      congestion was associated with liver enzymes elevation suggesting a possible 
      cardio-hepatic syndrome.
FAU - Bannon, Lian
AU  - Bannon L
AD  - Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 64239, Israel.
FAU - Merdler, Ilan
AU  - Merdler I
AUID- ORCID: 0000-0003-3294-5968
AD  - Cardiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
FAU - Bar, Nir
AU  - Bar N
AD  - Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center, 
      Tel Aviv 64239, Israel.
FAU - Lupu, Lior
AU  - Lupu L
AUID- ORCID: 0000-0003-4873-2887
AD  - Cardiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
FAU - Banai, Shmuel
AU  - Banai S
AD  - Cardiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
FAU - Jacob, Giris
AU  - Jacob G
AD  - Internal Medicine F, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
FAU - Shacham, Yacov
AU  - Shacham Y
AD  - Cardiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel.
LA  - eng
PT  - Journal Article
DEP - 20211123
PL  - Switzerland
TA  - J Pers Med
JT  - Journal of personalized medicine
JID - 101602269
PMC - PMC8707113
OTO - NOTNLM
OT  - ACLI
OT  - STEMI
OT  - acute heart failure (AHF)
OT  - acute liver injury
OT  - cardiac hepatopathy
OT  - cardio hepatic
OT  - liver enzymes
COIS- The authors declare no conflict of interest.
EDAT- 2021/12/25 06:00
MHDA- 2021/12/25 06:01
PMCR- 2021/11/23
CRDT- 2021/12/24 01:09
PHST- 2021/10/17 00:00 [received]
PHST- 2021/11/20 00:00 [revised]
PHST- 2021/11/20 00:00 [accepted]
PHST- 2021/12/24 01:09 [entrez]
PHST- 2021/12/25 06:00 [pubmed]
PHST- 2021/12/25 06:01 [medline]
PHST- 2021/11/23 00:00 [pmc-release]
AID - jpm11121241 [pii]
AID - jpm-11-01241 [pii]
AID - 10.3390/jpm11121241 [doi]
PST - epublish
SO  - J Pers Med. 2021 Nov 23;11(12):1241. doi: 10.3390/jpm11121241.