Association of Hemodynamic Parameters with Fibrosis-4 Index, a Noninvasive Maker to Assess Liver Function, among Patients with Compensated Heart Failure

Background: Fibrosis-4 index (FIB-4 index) is defined as age (years) × AST[U/L]/(platelet count[10⁹/L] × ALT[U/L] ^1/2) and has been utilized as a marker of liver fibrosis. Previously, we reported FIB-4 index is associated with poor outcome among patients with heart failure (HF) but its mechanism remains unknown. Methods: Between January and December 2015, 305 HF patients admitted to our hospital. Among them, 70 patients underwent right heart catheter, and 19 patients were excluded due to decompensated HF and undergoing hemodialysis. Then, 51 patients who had compensated HF were enrolled in this study. These patients were sub-grouped according to whether they have above or below the median value of FIB-4 index, which was 2.20, designated low FIB-4 (n = 25) and high FIB-4 (n = 26) groups. Results: Neither of age, systolic pressure or BNP significantly differed between two groups. Right atrial pressure (RAP) was significantly higher in high FIB-4 group (8.6 ± 4.1 mmHg) compared with low FIB-4 counterpart (6.1 ± 4.3 mmHg). High FIB-4 group had also higher mean pulmonary artery pressure (26.2 ± 9.3 mmHg) as well as pulmonary capillary wedge pressure (17.2 ± 6.2 mmHg) compared with comparable values in low FIB-4 group that were 21.2 ± 7.6 and 13.6 ± 6.8 mmHg, respectively (P < .05). FIB-4 index showed significant correlation with RAP (R = 0.38, P < .01), but not with mPAP or PCWP. Conclusion: RAP was significantly associated with FIB-4 index in patients with clinically compensated HF.