ArticleClinical research in cardiology : official journal of the German Cardiac Society2023
Cardio-hepatic syndrome in patients undergoing transcatheter aortic valve replacement.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 6 citations in OpenAlex.
- Development of atrioventricular valve regurgitation following transcatheter aortic valve replacement for severe aortic stenosis.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Aortic regurgitation is associated with African American and Asian race, smoking, renal disease, and numerous autoimmune diseases in addition to traditional cardiovascular risk factors but has lower risk with alcohol intake.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Impact of cardiohepatic syndrome on postoperative mortality in heart failure patients with reduced ejection fraction undergoing coronary artery bypass grafting.Journal of cardiothoracic surgery · 2026Article
- Prognostic value of liver shear wave elastography after transcatheter aortic valve implantation in severe aortic stenosis.International journal of cardiology. Heart & vasculature · 2026Article
- The Prognostic Value of Platelet-Albumin-Bilirubin Score in Patients Undergoing Transcatheter Aortic Valve Replacement.Clinical cardiology · 2025Article
- Prognostic Value of the Tricuspid Regurgitation Impact on Outcomes (TRIO) Score in Patients Undergoing Transcatheter Aortic Valve Implantation.Reviews in cardiovascular medicine · 2025Article
- Causal Relationship between Angina and Hepatic Failure as Revealed by Mendelian Randomization.Journal of clinical medicine · 2024Article
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Authors and funding
18 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiohepatic syndrome (CHS) has been identified as an important but underrecognized survival predictor in multiple cardiovascular disease entities. The objectives of this study were to evaluate the prevalence and prognostic value of CHS in patients undergoing TAVR for severe aortic stenosis (AS).
methodsThe study included patients with available laboratory parameters of hepatic function who underwent TAVR from July 2013 until December 2019 at our center. CHS was defined as an elevation of at least two of three laboratory cholestasis parameters above the upper limit of normal (bilirubin, alkaline phosphatase, and gamma glutamyl transferase). Study endpoints were three-year survival, technical and device failure (VARC 3), as well as New York Heart Association (NYHA) functional class at follow-up.
resultsAmong a total of 953 analyzed patients (47.6% females, median age 80.0 [76.0-85.0] years) CHS was present in 212 patients (22.4%). In patients with vs. without CHS, rates of technical (6.1% vs. 8.4%, p = 0.29) and device failure (18.9% vs. 17.3%, p = 0.59) were comparable. NYHA functional class at baseline and follow-up was more severe in patients with CHS. Nevertheless, heart failure symptoms improved from baseline to follow-up irrespective of hepatic function. Three-year survival rates were significantly lower in patients with CHS (49.4 vs. 65.4%, p < 0.001). The predictive value of CHS persisted after adjustment in a multivariable analysis (hazard ratio 1.58, p < 0.01).
conclusionIn patients undergoing TAVR, CHS is prevalent in 22% of patients and is associated with increased postinterventional mortality. Thus, CHS should be included in the decision-making process within the TAVR heart team. Cardiohepatic syndrome (CHS) as defined by an elevation of at least two of three laboratory cholestasis parameters above the upper limit of normal was prevalent in 22% of patients undergoing TAVR for severe AS. The presence of CHS was associated with more severe heart failure symptoms and worse three-year survival.
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