The following is a summary of “Association Between Non-Clinically Apparent Liver Fibrosis and Pulmonary Arterial Hypertension in Hispanic Patients,” published in the December 2023 issue of Cardiology by Kalas et al.
Pulmonary arterial hypertension (PAH), a deadly disease with impaired liver function, disproportionately affects Hispanics who often have advanced non-alcoholic fatty liver disease (NAFLD), raising questions about its clinical impact.
Researchers conducted a retrospective study to assess the utility of the non-alcoholic fatty liver disease fibrosis score (NFS) in predicting liver fibrosis severity in a Hispanic PAH cohort, examining its associations with hemodynamics, functional class, and clinical outcomes.
They conducted a retrospective review of treatment-naive Hispanic patients with group I WHO pulmonary hypertension (PH) at a single academic center (February 2016 to March 2021). Exclusions included patients with a substance or alcohol abuse history, non-group I WHO PH, pre-existing liver disease, chronic kidney disease, atrial fibrillation, thyroid disease, and warfarin use. Group I WHO PH diagnosis was confirmed via cardiac catheterization post-exclusion of other etiologies. NFS was computed for each patient and correlated with functional capacity, hemodynamics, N-terminal-pro-B-type natriuretic peptide (NT-proBNP) levels, and survival.
The results showed that among 96 Hispanic patients, the median age was 49 years (IQR: 15), with 69% being females. Higher NFSs, indicating advanced hepatic fibrosis (F3-F4), correlated with elevated right-sided cardiac filling pressures (r = 0.27, P=0.03), elevated levels of NT-proBNP (r = 0.32, P=0.01), decreased 6-minute walk distance (6MWD) (r = -0.49, P=0.001), diminished functional capacity (WHO functional class (WHO-FC), r = -0.35, P= 0.051), a higher prevalence of diabetes (21.1% versus 51.9%, P=0.001), a higher prevalence of risk factors for metabolic syndrome (81.5% versus 65.0%, P=0.035), and poorer 5-year survival rates.
Investigators concluded that in Hispanic PAH patients, liver fibrosis scores predict lower survival and enhance risk assessment, urging liver disease screening for earlier intervention and potentially improved outcomes.
Source: cardiologyres.org/index.php/Cardiologyres/article/view/1565
