Diagnostic and Interventional Radiology
Cardiovascular Imaging - Original Article

Liver stiffness value obtained by point shear-wave elastography is significantly related with atrial septal defect size

1.

Department of Cardiology, University of Health Sciences Adana Health Practice and Research Center, Adana, Turkey

2.

Department of Radiology, University of Health Sciences Adana Health Practice and Research Center, Adana, Turkey

3.

Department of Internal Medicine, University of Health Sciences Adana Health Practice and Research Center, Adana, Turkey

Diagn Interv Radiol 2020; 26: 284-291
DOI: 10.5152/dir.2019.19287
Read: 293 Downloads: 160 Published: 25 November 2019

PURPOSE

The increase in volume and pressure in the right atrium (RA) and right ventricle (RV) has been shown to increase the liver stiffness (LS). In the literature, there is no information about the changes in LS value in patients with atrial septal defect (ASD). The aim of our study was to investigate the change of LS values obtained by point shear-wave elastography (pSWE) in patients with ASD and the clinical utility of pSWE for this disease.

 

METHODS

This cross-sectional study included 66 patients with ostium secundum ASD: 21 patients with no indication for ASD closure (Group I), 38 patients who underwent ASD closure (Group II), and 7 patients who had ASD with Eisenmenger syndrome (Group III). All patients underwent echocardiography and pSWE.  Increased LS was accepted as ≥7 kPa.

 

RESULTS

LS values as well as transaminases, clinical signs of heart failure and functional and structural heart abnormalities (increase of RA and RV diastolic dimensions, tricuspid regurgitation pressure gradient [TRPG], ASD size and decrease of ejection fraction, tricuspid annular plane systolic excursion) significantly increased from Group I to Group III (P < 0.001 for all comparisons). Mean LS values for Group I, Group II, and Group III were 5.16±1.55 kPa, 7.48±1.99 kPa, and 13.9±2.58 kPa, respectively. In multivariate linear regression analysis, ASD size and TRPG were significantly associated with LS increase. Only ASD size independently predicted abnormal LS increase ≥7 kPa according to multivariate logistic regression. Clinical value of LS increase was comparable to TRPG for detection of Eisenmenger syndrome; in the receiver operating curve analysis, area under the curve was 0.995 for LS (P < 0.001) and 0.990 for TRPG (P < 0.001). At 10 kPa threshold, LS determined the Eisenmenger syndrome with 100% sensitivity and 91.5% specificity.

 

CONCLUSION

LS value assessed by pSWE was significantly increased in ASD patients with closure indication and Eisenmenger syndrome compared to patients without ASD closure indication and was comparable with TRPG in regards to Eisenmenger syndrome identification. ASD size significantly associated with LS and independently predicted abnormal LS increase ≥7 kPa.

 

You may cite this article as: Küçükosmanoğlu M, Koç AS, Sümbül HE, Koca H, Pekoz BC, Koç M. Liver stiffness value obtained by point shear-wave elastography is significantly related with atrial septal defect size. Diagn Interv Radiol 2020; 26:284–291.

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