Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure.
AIMS: Liver dysfunction due to heart failure (HF) is often referred to as cardiac or congestive hepatopathy. The composite Model for End-Stage Liver Disease excluding INR (MELD-XI) is a robust scoring system of liver function, and a high score is associated with poor prognosis in advanced HF patient...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4067358?pdf=render |
| _version_ | 1818586378085072896 |
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| author | Satoshi Abe Akiomi Yoshihisa Mai Takiguchi Takeshi Shimizu Yuichi Nakamura Hiroyuki Yamauchi Shoji Iwaya Takashi Owada Makiko Miyata Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Koichi Sugimoto Hiroyuki Kunii Kazuhiko Nakazato Hitoshi Suzuki Shu-ichi Saitoh Yasuchika Takeishi |
| author_facet | Satoshi Abe Akiomi Yoshihisa Mai Takiguchi Takeshi Shimizu Yuichi Nakamura Hiroyuki Yamauchi Shoji Iwaya Takashi Owada Makiko Miyata Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Koichi Sugimoto Hiroyuki Kunii Kazuhiko Nakazato Hitoshi Suzuki Shu-ichi Saitoh Yasuchika Takeishi |
| author_sort | Satoshi Abe |
| collection | DOAJ |
| description | AIMS: Liver dysfunction due to heart failure (HF) is often referred to as cardiac or congestive hepatopathy. The composite Model for End-Stage Liver Disease excluding INR (MELD-XI) is a robust scoring system of liver function, and a high score is associated with poor prognosis in advanced HF patients with a heart transplantation and/or ventricular assist device. However, the impact of MELD-XI on the prognosis of HF patients in general remains unclear. METHODS AND RESULTS: We retrospectively analyzed 562 patients who were admitted to our hospital for the treatment of decompensated HF. A MELD-XI score was graded, and patients were divided into two groups based on the median value of MELD-XI score: Group L (MELD-XI <10, n = 289) and Group H (MELD-XI ≥10, n = 273). We compared all-cause mortality and echocardiographic findings between the two groups. In the follow-up period (mean 471 days), 104 deaths (62 cardiac deaths and 42 non-cardiac deaths) were observed. The event (cardiac death, non-cardiac death, all-cause death)-free rate was significantly higher in group L than in group H (logrank P<0.05, respectively). In the Cox proportional hazard analysis, a high MELD-XI score was found to be an independent predictor of cardiac deaths and all-cause mortality in HF patients. Regarding echocardiographic parameters, right atrial and ventricular areas, inferior vena cava diameter, and systolic pulmonary artery pressure were higher in group H than in group L (P<0.05, respectively). CONCLUSIONS: The MELD-XI scoring system, a marker of liver function, can identify high-risk patients with right heart volume overload, higher pulmonary arterial pressure and multiple organ failure associated with HF. |
| first_indexed | 2024-12-16T08:52:00Z |
| format | Article |
| id | doaj.art-39911215195340399cfa76f433747823 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T08:52:00Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-39911215195340399cfa76f4337478232022-12-21T22:37:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0196e10061810.1371/journal.pone.0100618Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure.Satoshi AbeAkiomi YoshihisaMai TakiguchiTakeshi ShimizuYuichi NakamuraHiroyuki YamauchiShoji IwayaTakashi OwadaMakiko MiyataTakamasa SatoSatoshi SuzukiMasayoshi OikawaAtsushi KobayashiTakayoshi YamakiKoichi SugimotoHiroyuki KuniiKazuhiko NakazatoHitoshi SuzukiShu-ichi SaitohYasuchika TakeishiAIMS: Liver dysfunction due to heart failure (HF) is often referred to as cardiac or congestive hepatopathy. The composite Model for End-Stage Liver Disease excluding INR (MELD-XI) is a robust scoring system of liver function, and a high score is associated with poor prognosis in advanced HF patients with a heart transplantation and/or ventricular assist device. However, the impact of MELD-XI on the prognosis of HF patients in general remains unclear. METHODS AND RESULTS: We retrospectively analyzed 562 patients who were admitted to our hospital for the treatment of decompensated HF. A MELD-XI score was graded, and patients were divided into two groups based on the median value of MELD-XI score: Group L (MELD-XI <10, n = 289) and Group H (MELD-XI ≥10, n = 273). We compared all-cause mortality and echocardiographic findings between the two groups. In the follow-up period (mean 471 days), 104 deaths (62 cardiac deaths and 42 non-cardiac deaths) were observed. The event (cardiac death, non-cardiac death, all-cause death)-free rate was significantly higher in group L than in group H (logrank P<0.05, respectively). In the Cox proportional hazard analysis, a high MELD-XI score was found to be an independent predictor of cardiac deaths and all-cause mortality in HF patients. Regarding echocardiographic parameters, right atrial and ventricular areas, inferior vena cava diameter, and systolic pulmonary artery pressure were higher in group H than in group L (P<0.05, respectively). CONCLUSIONS: The MELD-XI scoring system, a marker of liver function, can identify high-risk patients with right heart volume overload, higher pulmonary arterial pressure and multiple organ failure associated with HF.http://europepmc.org/articles/PMC4067358?pdf=render |
| spellingShingle | Satoshi Abe Akiomi Yoshihisa Mai Takiguchi Takeshi Shimizu Yuichi Nakamura Hiroyuki Yamauchi Shoji Iwaya Takashi Owada Makiko Miyata Takamasa Sato Satoshi Suzuki Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Koichi Sugimoto Hiroyuki Kunii Kazuhiko Nakazato Hitoshi Suzuki Shu-ichi Saitoh Yasuchika Takeishi Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. PLoS ONE |
| title | Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. |
| title_full | Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. |
| title_fullStr | Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. |
| title_full_unstemmed | Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. |
| title_short | Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. |
| title_sort | liver dysfunction assessed by model for end stage liver disease excluding inr meld xi scoring system predicts adverse prognosis in heart failure |
| url | http://europepmc.org/articles/PMC4067358?pdf=render |
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