Liver Function Abnormalities in Patients with Acute Heart Failure in Sohag University Hospitals | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 101, Issue 1, October 2025, Pages 5084-5093 PDF (824.86 K) | ||
| DOI: 10.21608/ejhm.2025.458362 | ||
| Abstract | ||
| Background: Liver dysfunction is a frequently under-recognized complication in patients with acute heart failure (AHF), contributing to adverse outcomes and reflecting underlying hemodynamic compromise. Objective: This study aimed to evaluate liver function tests (LFTs) abnormalities in patients with AHF and to identify cardiac and non-cardiac factors associated with hepatic impairment. Patients and methods: This observational study included 100 adult patients presenting with AHF to the Internal Medicine and Cardiology Departments at Sohag University Hospitals. Clinical evaluation, laboratory investigations (including LFTs, CBC, renal function, lipid profile, and cardiac biomarkers), echocardiography, chest radiography, and abdominal ultrasound were performed. Patients were classified according to AHF type, ejection fraction phenotype, and presence of valvular disease. Associations between LFTs abnormalities and echocardiographic parameters, AHF subtypes, and comorbidities were statistically analyzed. Results: Elevated liver enzymes were common, with ALT and AST abnormal in 85% and 92% of patients respectively. Hypoalbuminemia was observed in 60%, total bilirubin was elevated in 34%, and INR was abnormal in 27%. Tricuspid regurgitation (TR) and mitral regurgitation (MR) were present in 65% and 60% of cases respectively, and showed significant associations with worsening liver parameters. Patients with reduced ejection fraction (HFrEF) and those presenting with cardiogenic shock or acute coronary syndrome (ACS) had significantly higher levels of ALT, AST, and bilirubin. Hepatic ultrasound revealed congestive liver changes in 70% of patients. Significant correlations were found between LFT abnormalities and TR severity, MR severity, reduced EF, and presence of ACS (p < 0.05). Conclusion: Hepatic dysfunction was common in AHF, associated with reduced function, regurgitation, shock, and ACS. Enzyme and bilirubin elevations reflected valvular severity, while hepatic congestion showed weaker associations. | ||
| Keywords | ||
| Acute heart failure; Liver function tests; Tricuspid regurgitation; Hepatic congestion; Ejection fraction | ||
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