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DOI: 10.1055/s-0034-1394042
Noninvasive assessment of liver function in adults with congenital heart disease (ACHD) by transient elastography (Fibroscan), Acoustic Radiation Force Impulse Imaging (ARFI) and biochemical markers
Objectives: To assess the impact of ultrasound based procedures (USBP) and specific biochemical fibrosis markers (BFM) on noninvasive staging of liver fibrosis/cirrhosis (LF/LC) in ACHD.
Methods: Patients after atrial switch operation (ASO), Fontan procedure or with Eisenmenger syndrome (ES) were studied prospectively using clinical data and USBP. Blood samples were taken for laboratory analysis, including conventional liver tests and BFM.
Results: 50 adults (median age 33,5 y; 18 f) were enrolled. As a result, 16 pts showed signs of hepatic damage in USBP. Most pts with increased hepatic stiffness in the USBP had normal BFM of LF/LC. Overall, regarding imaging and laboratory analysis, 62% patients had signs of liver pathology.
Conclusions: Noninvasive USBP, such as Fibroscan and ARFI, are useful noninvasive methods for detection of liver stiffness, while BFM were not indicative for LF/LC in ACHD. For targeted screening of hepatic involvement in CHD, it seems to be crucial that not a single analysis, but several complementary methods, such as USBP and liver serotests, are performed. Only combined consideration of noninvasive procedures lead to a meaningful diagnosis of hepatic damage.