PMID- 38187513
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240109
IS  - 1923-2829 (Print)
IS  - 1923-2837 (Electronic)
IS  - 1923-2829 (Linking)
VI  - 14
IP  - 6
DP  - 2023 Dec
TI  - The Association Between Non-Clinically Apparent Liver Fibrosis and Pulmonary 
      Arterial Hypertension in Hispanic Patients.
PG  - 429-436
LID - 10.14740/cr1565 [doi]
AB  - BACKGROUND: Pulmonary arterial hypertension (PAH) is a deadly cardiopulmonary 
      disease with multi-organ involvement including impaired liver function. Liver 
      dysfunction in PAH is poorly understood but significantly associated with 
      morbidity and mortality. Hispanics have a significantly higher prevalence of 
      non-alcoholic fatty liver disease (NAFLD) and evidence of more advanced disease 
      in comparison to other ethnic groups. The clinical impact of NAFLD in Hispanic 
      PAH patients is unknown. We aimed to investigate the impact of a validated 
      scoring system, non-alcoholic fatty liver disease fibrosis score (NFS), to 
      predict the degree of liver fibrosis in a Hispanic PAH population and its 
      relationship to hemodynamics, functional class, and outcomes. METHODS: A 
      retrospective review of all treatment-naive Hispanic patients with group I World 
      Health Organization (WHO) pulmonary hypertension (PH) at a single academic center 
      between February 2016 and March 2021 was performed. Patients with history of 
      substance or alcohol abuse, non-group I WHO PH, pre-existent liver disease, 
      chronic kidney disease, atrial fibrillation, thyroid disease, and warfarin use 
      were excluded from the study. The diagnosis of group I WHO PH was determined by 
      cardiac catheterization after the exclusion of other etiologies. NFS was 
      calculated for each patient and correlated with functional capacity, 
      hemodynamics, N-terminal-pro-B-type natriuretic peptide (NT-proBNP), and 
      survival. RESULTS: A total of 96 Hispanic patients were included in our study. 
      The median age of patients in our cohort was 49 years (interquartile range: 15) 
      and 69% of our cohort were females. Higher NFSs indicating advanced hepatic 
      fibrosis (F3-F4) were found to correlate with elevated right-sided cardiac 
      filling pressures (r = 0.27, P = 0.03), elevated levels of NT-proBNP (r = 0.32, P 
      = 0.01), lower 6-minute walk distance (6MWD) (r = -0.49, P = 0.001), lower 
      functional capacity (World Health Organization functional class, WHO-FC, r = 
      -0.35, P = 0.051), a higher prevalence of diabetes (21.1% versus 51.9%, P = 
      0.001), a higher prevalence of risk factors for metabolic syndrome (81.5% versus 
      65.0%, P = 0.035), and worse 5-year survival rates. CONCLUSION: In Hispanic 
      patients with PAH, NFSs correlate with the degree of right-sided pressure 
      overload. In addition, advanced NFSs were independently associated with lower 
      5-year survival rates and added prognostic information to other established risk 
      parameters in PAH. This study suggests that screening for liver disease in this 
      vulnerable patient population can aid in earlier detection leading to discussion 
      of lifestyle modifications and possible escalation of PAH-targeted therapies, 
      thus leading to potential improvement in survival rates.
CI  - Copyright 2023, Kalas et al.
FAU - Kalas, M Ammar
AU  - Kalas MA
AD  - Division of Gastroenterology, Texas Tech University Health Sciences Center El 
      Paso, El Paso, TX 79905, USA.
FAU - Khatab, Yacoub
AU  - Khatab Y
AD  - Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center 
      El Paso, El Paso, TX 79905, USA.
FAU - Galura, Gian
AU  - Galura G
AD  - Division of Gastroenterology, Texas Tech University Health Sciences Center El 
      Paso, El Paso, TX 79905, USA.
FAU - Alkhateeb, Haider
AU  - Alkhateeb H
AD  - Division of Cardiology, Texas Tech University Health Sciences Center El Paso, El 
      Paso, TX 79905, USA.
FAU - Mukherjee, Debabrata
AU  - Mukherjee D
AUID- ORCID: 0000-0002-5131-3694
AD  - Division of Cardiology, Texas Tech University Health Sciences Center El Paso, El 
      Paso, TX 79905, USA.
FAU - Garcia, Hernando
AU  - Garcia H
AD  - Division of Pulmonary and Critical Care Medicine, Mount Sinai Medical Center, 
      Miami Beach, FL 33140, USA.
FAU - Zuckerman, Marc
AU  - Zuckerman M
AD  - Division of Gastroenterology, Texas Tech University Health Sciences Center El 
      Paso, El Paso, TX 79905, USA.
FAU - Nickel, Nils Patrick
AU  - Nickel NP
AD  - Division of Pulmonary and Critical Care Medicine, Texas Tech University Health 
      Sciences Center El Paso, El Paso, TX 79905, USA.
LA  - eng
PT  - Journal Article
DEP - 20231209
PL  - Canada
TA  - Cardiol Res
JT  - Cardiology research
JID - 101557543
PMC - PMC10769614
OTO - NOTNLM
OT  - Liver fibrosis
OT  - Non-alcoholic fatty liver disease fibrosis score
OT  - Non-invasive assessment
OT  - Pulmonary arterial hypertension
COIS- None to declare.
EDAT- 2024/01/08 06:42
MHDA- 2024/01/08 06:43
PMCR- 2023/12/09
CRDT- 2024/01/08 04:44
PHST- 2023/08/30 00:00 [received]
PHST- 2023/10/03 00:00 [accepted]
PHST- 2024/01/08 06:43 [medline]
PHST- 2024/01/08 06:42 [pubmed]
PHST- 2024/01/08 04:44 [entrez]
PHST- 2023/12/09 00:00 [pmc-release]
AID - 10.14740/cr1565 [doi]
PST - ppublish
SO  - Cardiol Res. 2023 Dec;14(6):429-436. doi: 10.14740/cr1565. Epub 2023 Dec 9.