Liver congestion assessed by hepatic vein waveforms in patients with heart failure

Abstract Background It has been reported that the pattern of hepatic vein (HV) waveforms determined by abdominal ultrasonography is useful for the diagnosis of hepatic fibrosis in patients with chronic liver disease. We here aimed to clarify the clinical implications of HV waveform patterns in patients with heart failure (HF). Methods We measured HV waveforms in 350 HF patients, who were then classified into three categories based on their waveforms: those with a continuous pattern (C group); those whose V wave ran under the baseline (U group), and those with a reversed V wave (R group). We performed right-heart catheterization, and examined the rate of post-discharge cardiac events, such as cardiac death and rehospitalization due to worsening HF. Results The number of patients in each of the three HV waveform groups was as follows: C group, n = 158; U group, n = 152, and R group, n = 40. The levels of B-type natriuretic peptide (R vs. C and U; 245.8 vs. 111.7 and 216.6 pg/mL, P Conclusion Among HF patients, those with reversed V waves had higher right atrial pressure and were at higher risk of adverse prognosis.