DOI
https://doi.org/10.47689/2181-3663-vol4-iss5-pp12-21Keywords
liver fibrosis , chronic heart failure , quality of life , transient elastography , psychofunctional impairmentsAbstract
Purpose of the study: To assess the influence of liver fibrosis severity, determined by transient elastography, on the psychofunctional characteristics of patients with chronic heart failure (CHF).
Material and methods: The study included 130 patients with clinically confirmed CHF (NYHA class II-IV, stable course, age 45-75 years) with signs of liver congestion. Decompensated conditions, cirrhosis, alcoholic hepatitis, oncological pathology, and pronounced cognitive impairments were excluded. All patients were divided into four groups according to liver stiffness: <7.0; 7.0-9.5; 9.5-12.5; >12.5 kPa. Quality of life was assessed using the SF-36 questionnaire, anxiety and depression levels were assessed using the HADS scale, and physical activity was assessed using the PASE scale. Statistical analysis: ANOVA, Spearman correlation; critical significance level p<0.05.
Results: Increased liver fibrosis was statistically associated with a significant decrease in all quality of life indicators (in all eight SF-36 domains), an increase in anxiety scores (HADS-A) and depression scores (HADS-D), and a decrease in physical activity scores (PASE) (p<0.05 in all cases). For example, the average PF score (physical functioning) decreased from 66.2±8.7 (<7.0 kPa) to 46.5±8.4 (>12.5 kPa), and the average PASE index decreased from 123±18.5 to 87±13.5 points.
Conclusions: Liver fibrosis serves as a significant predictor of psychofunctional state deterioration in patients with CHF. Progressive liver stiffness is associated with deterioration of general well-being, decreased physical activity, and increased anxiety-depressive symptoms. Non-invasive assessment of fibrosis severity (elastography) can be used as an additional tool for risk stratification and optimization of CHF therapy.
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