Table 4.
Association between elevated hepatic laboratory values and hemodynamic, echocardiographic, physical examination, and treatment-related parameters.
| INR (n=511) | Bilirubin (n=450) | AP (n=453) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Elevated | Normal | P | Elevated | Normal | P | Elevated | Normal | P | |
|
|
|||||||||
| Pulmonary artery catheter parameters (n=186) | |||||||||
| Pulmonary capillary wedge pressure (mm/Hg) | 22.4 ± 8.5 | 20.6 ± 9.5 | 0.307 | 21.9 ± 7.6 | 21.3 ± 9.0 | 0.718 | 21.8 ± 7.7 | 21.4 ± 8.9 | 0.822 |
| Right atrial pressure (mm/Hg) | 12.4 ± 7.5 | 7.1 ± 4.1 | <0.001* | 12.2 ± 7.0 | 8.7 ± 5.2 | 0.005* | 11.9 ± 6.4 | 9.1 ± 5.9 | 0.015* |
| Cardiac index (L/min/m2) | 2.2 ± 0.9 | 2.2 ± 0.5 | 0.851 | 2.0 ± 0.6 | 2.2 ± 0.5 | 0.122 | 2.1 ± 0.5 | 2.1 ± 0.6 | 0.964 |
| Systolic blood pressure (mmHg) | 126.6 ± 30.9 | 149.2 ± 35.7 | <0.001* | 125.7 ± 31.4 | 136.9 ± 33.1 | 0.001* | 135.7 ± 32.7 | 130.3 ± 32.7 | 0.083 |
| Diastolic blood pressure (mmHg) | 77.0 ± 20.6 | 84.8 ± 22.3 | <0.001* | 79.1 ± 22.3 | 79.7 ± 20.2 | 0.805 | 80.9 ± 21.0 | 77.3 ± 20.5 | 0.062 |
| Echo parameters (n=807) | |||||||||
| Moderate to severe RV dysfunction | 64.6% | 29.0% | <0.001* | 65.4% | 35.8% | <0.001* | 52.1% | 34.9% | <0.001* |
| Moderate to severe RV dilation | 43.8% | 16.5% | <0.001* | 51.8% | 21.7% | <0.001* | 34.8% | 26.7% | 0.069 |
| Moderate to severe RA dilation | 16.0% | 4.7% | <0.001* | 21.9% | 6.8% | <0.001* | 15.0% | 8.4% | 0.036* |
| Moderate to severe tricuspid regurgitation | 24.4% | 24.7% | <0.001* | 53.8% | 35.1% | <0.001* | 46.8% | 33.9% | 0.008* |
| Lack of IVC inspiratory collapse | 27.6% | 6.1% | <0.001* | 27.0% | 14.7% | 0.005* | 23.2% | 12.5% | 0.009* |
| Physical Examination (baseline) | |||||||||
| Moderate to severe edema | 43.6% | 26.3% | <0.001* | 33.0% | 30.0% | 0.497 | 64.4% | 49.0% | 0.001* |
| Jugular venous distention | 43.8% | 27.6% | <0.001* | 37.5% | 62.5% | 0.416 | 65.2% | 50.0% | 0.003* |
| Hepatojugular reflux | 42.5% | 31.0% | 0.054 | 43.7% | 26.2% | 0.004* | 59.7% | 56.6% | 0.633 |
| Miscellaneous | |||||||||
| Baseline B-type natriuretic peptide (pg/mL) | 2060 ± 1251 | 1444 ± 1115 | <0.001* | 2057 ± 1237 | 1580 ± 1155 | <0.001* | 1899 ± 1231 | 1520 ± 1148 | 0.001* |
| Loop diuretic dose (mg)† | 172.9 ± 179.3 | 107.3 ± 99.4 | <0.001* | 149.2 ± 141.3 | 128.6 ± 124.6 | 0.125 | 152.3 ± 139.2 | 112.7 ± 112.5 | 0.001* |
| Net fluid output (L) | −7.2 ± 9.0 | −3.7 ± 4.4 | <0.001* | −6.0 ± 8.6 | −4.3 ± 5.6 | 0.053 | −5.7 ± 7.6 | −3.7 ± 5.3 | 0.004* |
| Inotrope use during the admission | 22.9% | 9.5% | <0.001* | 29.1% | 12.7% | <0.001* | 14.1% | 22.6% | 0.021* |
| AST (n=432) | ALT (n=432) | |||||
|---|---|---|---|---|---|---|
| Elevated | Normal | P | Elevated | Normal | P | |
|
|
||||||
| Pulmonary artery catheter parameters (n=186) | ||||||
| Pulmonary capillary wedge pressure (mm/Hg) | 20.6 ± 8.9 | 22.6 ± 8.7 | 0.277 | 21.5 ± 7.9 | 22.1 ± 9.2 | 0.751 |
| Right atrial pressure (mm/Hg) | 10.8 ± 6.3 | 9.7 ± 6.0 | 0.368 | 9.9 ± 5.9 | 10.1 ± 6.2 | 0.890 |
| Cardiac index (L/min/m2) | 2.0 ± 0.4 | 2.1 ± 0.7 | 0.425 | 2.0 ± 0.4 | 2.1 ± 0.7 | 0.358 |
| Systolic blood pressure (mmHg) | 131.8 ± 31.9 | 134.1 ± 33.4 | 0.471 | 130.7 ± 33.2 | 134.2 ± 32.8 | 0.348 |
| Diastolic blood pressure (mmHg) | 81.5 ± 22.4 | 77.8 ± 19.5 | 0.075 | 79.7 ± 20.4 | 79.2 ± 20.9 | 0.831 |
| Echo parameters (n=807) | ||||||
| Moderate to severe RV dysfunction | 52.8% | 40.5% | 0.014* | 57.1% | 41.5% | 0.007* |
| Moderate to severe RV dilation | 36.3% | 28.2% | 0.084 | 29.6% | 31.8% | 0.683 |
| Moderate to severe RA dilation | 11.9% | 11.2% | 0.823 | 8.2% | 12.5% | 0.243 |
| Moderate to severe tricuspid regureitation | 44.1% | 38.1% | 0.239 | 37.6% | 41.3% | 0.534 |
| Lack of IVC inspiratory collapse | 24.2% | 116.4% | 0.075 | 21.0% | 18.9% | 0.684 |
| Physical Examination (baseline) | ||||||
| Moderate to severe edema | 41.0% | 35.7% | 0.256 | 22.1% | 23.9% | 0.650 |
| Jugular venous distention | 41.7% | 37.4% | 0.399 | 25.2% | 22.5% | 0.548 |
| Hepatojugular reflux | 35.7% | 41.3% | 0.396 | 29.0% | 23.3% | 0.328 |
| Miscellaneous | ||||||
| Baseline B-type natriuretic peptide (pg/mL) | 2004 ± 1232 | 1560 ± 1156 | 0.001* | 1996 ± 1276 | 1683 ± 1168 | 0.022* |
| Loop diuretic dose (mg)† | 141.7 ± 145.2 | 122.5 ± 111.6 | 0.128 | 131.8 ± 117.9 | 129.6 ± 127.9 | 0.884 |
| Net fluid output (L) | −5.4 ± 8.3 | −4.4 ± 5.8 | 0.181 | −5.8 ± 9.4 | −4.5 ± 5.8 | 0.143 |
| Inotrope use during the admission | 16.0% | 18.1% | 0.592 | 16.4% | 19.4% | 0.485 |
ALT: Alanine aminotransferase, AP: Alkaline phosphatase, AST: Aspartate aminotransferase, INR: International normalized ratio, IVC: Inferior vena cava, RA: Right atrial, RV: Right ventricular
*
Represents significant p-value.
†
Loop diuretic dose represents maximum dose given on any day of the hospitalization