Spleen stiffness dynamics as a marker of systemic venous congestion in decompensated chronic heart failure
N Khutsishvili, K Khalilova, I A Misan, O S Arisheva, I V Garmash, Z H D KobalavaAbstract
Objective
To evaluate spleen stiffness dynamics using transient elastography in hospitalized patients with chronic heart failure (CHF) and its association with liver stiffness.
Materials and Methods
The prospective study included 37 patients with decompensated CHF (mean age 74.8 ± 7.9 years; 37.8% male; NYHA class III–IV). The CHF diagnosis was confirmed according to current clinical guidelines. All patients underwent standard clinical, laboratory and instrumental examination along with transient elastography using a FibroScan 630 Expert device(Echosens, France) to measure liver and spleen stiffness at admission and discharge.
Results
At admission, patients with CHF had statistically significantly higher stiffness values for both the spleen [31.1 (22.9–48.1) kPa vs. 25.2 (20.9–32.3) kPa; p=0.001] and the liver [17.3 (10.2–29.1) kPa vs. 9.5 (8.1–15.4) kPa; p=0.001] compared to discharge. The presence of marked hepatomegaly was associated with increased spleen stiffness [33.2 (32.3–34.4) kPa vs. 22.3 (19.3–28.3) kPa; p=0.002]. A direct correlation was observed between spleen and liver stiffness (ρ=0.456; p=0.013). Patients with spleen stiffness above the median exhibited significantly higher liver stiffness [14.5 (9.1–17.3) kPa vs. 8.7 (6.4–11.0) kPa; p=0.001] compared to those below the median.
Conclusions
In decompensated CHF, spleen stiffness is significantly elevated at baseline and decreases following treatment, demonstrating reversible changes. The correlation between liver and spleen stiffness suggests concurrent involvement in systemic venous congestion. These findings support the concept of a cardio-splenal axis in CHF and indicate the potential clinical utility of spleen elastography for assessing congestion severity and dynamics in heart failure.