{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:40:47Z","timestamp":1786977647380,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":1923,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,9,13]],"date-time":"2020-09-13T00:00:00Z","timestamp":1599955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Grant-in-Aid for Early-Career Scientists"},{"name":"Nihon University School of Medicine 50th Anniversary Fund Research Grant"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Congestive splenomegaly is a classic sign of organ congestion in acute decompensated heart failure (ADHF). Shear wave elastography (SWE) allows the measurement of spleen stiffness (SS). We hypothesized that SS could quantify the severity of splenic congestion and predict adverse events in ADHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>This study included two cohorts: a haemodynamic cohort (62 HF patients) and an outcome cohort (115 ADHF patients). SS was measured by two-dimensional SWE on the same day of right heart catheterization in the haemodynamic cohort. Right atrial pressure (RAP) independently correlated with SS (\u03b2 = 0.32, P = 0.002). SS was measured in the outcome cohort before discharge. The 115 patients were divided into three groups on the basis of the tertile value of SS. The third tertile SS group had a higher prevalence of severe tricuspid regurgitation, higher N-terminal B-type natriuretic peptide (NT pro-BNP), and larger right ventricular diastolic diameter, than had the first tertile group and the second tertile group. During a median follow-up period of 105 (77\u2013135) days, adverse events occurred in 25 patients (one death and 24 rehospitalizations for HF). The third tertile SS group had a significantly higher rate of adverse events (P &amp;lt; 0.001). A higher SS was independently associated with adverse events after adjusting for conventional validated risk score, liver function test, liver stiffness, and estimated RAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The degree of SS at discharge can be used as a marker of residual splenic congestion, which is predictive of adverse events in patients with ADHF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13001","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:48:53Z","timestamp":1608662933000},"page":"4005-4014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Significance of Spleen Stiffness in Patients with Acute Decompensated Heart Failure"],"prefix":"10.1093","volume":"7","author":[{"given":"Yuki","family":"Saito","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Aizawa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Fukamachi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Kitano","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyama","family":"Kazuto","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidesato","family":"Fujito","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Sezai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,13]]},"reference":[{"key":"2026012115023147900_ehf213001-bib-0001","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/eurjhf\/hfn031","article-title":"Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program","volume":"11","author":"Allen","year":"2009","journal-title":"Eur J Heart Fail"},{"key":"2026012115023147900_ehf213001-bib-0002","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1136\/hrt.13.2.212","article-title":"Splenic enlargement in congestive heart failure and active rheumatic infection","volume":"13","author":"Ibrahim","year":"1951","journal-title":"Brit Heart J"},{"key":"2026012115023147900_ehf213001-bib-0003","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.jacc.2008.03.061","article-title":"Heart failure-related hospitalization in the U.S., 1979 to 2004","volume":"52","author":"Fang","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2026012115023147900_ehf213001-bib-0004","first-page":"273","article-title":"Integrative assessment of congestion in heart failure throughout the patient journey","volume":"6","author":"Girerd","year":"2018","journal-title":"JACC: Heart Fail"},{"key":"2026012115023147900_ehf213001-bib-0005","doi-asserted-by":"crossref","first-page":"735","DOI":"10.2214\/ajr.146.4.735","article-title":"\u201cCongestion index\u201d of the portal vein","volume":"146","author":"Moriyasu","year":"1986","journal-title":"Am J Roentgenol"},{"key":"2026012115023147900_ehf213001-bib-0006","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S0168-8278(98)80286-9","article-title":"Doppler sonography and hepatic vein catheterization in portal hypertension: assessment of agreement in evaluating severity and response to treatment","volume":"28","author":"Merkel","year":"1998","journal-title":"J Hepatol"},{"key":"2026012115023147900_ehf213001-bib-0007","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1007\/s12630-018-1125-z","article-title":"Imaging portal venous flow to aid assessment of right ventricular dysfunction","volume":"65","author":"Denault","year":"2018","journal-title":"Can J Anaesth"},{"key":"2026012115023147900_ehf213001-bib-0008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0165786","article-title":"Spleen stiffness is superior to liver stiffness for predicting esophageal varices in chronic liver disease: a meta-analysis","volume":"11","author":"Ma","year":"2016","journal-title":"PloS One"},{"key":"2026012115023147900_ehf213001-bib-0009","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1002\/jcu.22635","article-title":"Spleen and liver stiffness for noninvasive assessment of portal hypertension in cirrhotic patients with large esophageal varices","volume":"46","author":"Tseng","year":"2018","journal-title":"Journal of clinical ultrasound: JCU"},{"key":"2026012115023147900_ehf213001-bib-0010","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1056\/NEJM197112232852601","article-title":"The natural history of congestive heart failure: the Framingham study","volume":"285","author":"McKee","year":"1971","journal-title":"N Engl J Med"},{"key":"2026012115023147900_ehf213001-bib-0011","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s10396-019-00929-3","article-title":"The relationship of spleen stiffness value measured by shear wave elastography with age, gender, and spleen size in healthy volunteers","volume":"46","author":"Albayrak","year":"2019","journal-title":"J Med Ultrason"},{"key":"2026012115023147900_ehf213001-bib-0012","article-title":"EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (long version)","volume":"38","author":"Dietrich","year":"2017","journal-title":"Ultraschall der Medizin"},{"key":"2026012115023147900_ehf213001-bib-0013","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.echo.2010.05.010","article-title":"Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography","volume":"23","author":"Rudski","year":"2010","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012115023147900_ehf213001-bib-0014","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/2047487318810013","article-title":"Association of liver stiffness and cardiovascular outcomes in patients with heart failure: a systematic review and meta-analysis","volume":"27","author":"Khan","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2026012115023147900_ehf213001-bib-0015","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1016\/j.cgh.2009.05.033","article-title":"Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease","volume":"7","author":"Shah","year":"2009","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026012115023147900_ehf213001-bib-0016","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"key":"2026012115023147900_ehf213001-bib-0017","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.echo.2007.01.005","article-title":"Reappraisal of the use of inferior vena cava for estimating right atrial pressure","volume":"20","author":"Brennan","year":"2007","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012115023147900_ehf213001-bib-0018","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1093\/eurheartj\/ehs337","article-title":"Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies","volume":"34","author":"Pocock","year":"2013","journal-title":"Eur Heart J"},{"key":"2026012115023147900_ehf213001-bib-0019","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.ultrasmedbio.2008.08.018","article-title":"Quantitative viscoelasticity mapping of human liver using supersonic shear imaging: preliminary in vivo feasibility study","volume":"35","author":"Muller","year":"2009","journal-title":"Ultrasound Med Biol"},{"key":"2026012115023147900_ehf213001-bib-0020","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1002\/hep.26239","article-title":"Spleen stiffness: toward a noninvasive portal sphygmomanometer?","volume":"57","author":"Abraldes","year":"2013","journal-title":"Hepatology"},{"key":"2026012115023147900_ehf213001-bib-0021","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jacc.2008.05.068","article-title":"Importance of venous congestion for worsening of renal function in advanced decompensated heart failure","volume":"53","author":"Mullens","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2026012115023147900_ehf213001-bib-0022","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/eurheartj\/ehs444","article-title":"Clinical course and predictive value of congestion during hospitalization in patients admitted for worsening signs and symptoms of heart failure with reduced ejection fraction: findings from the EVEREST trial","volume":"34","author":"Ambrosy","year":"2013","journal-title":"Eur Heart J"},{"key":"2026012115023147900_ehf213001-bib-0023","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1002\/ehf2.12278","article-title":"Performance of the MAGGIC heart failure risk score and its modification with the addition of discharge natriuretic peptides","volume":"5","author":"Sawano","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2026012115023147900_ehf213001-bib-0024","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.jcmg.2017.10.022","article-title":"Liver stiffness reflecting right-sided filling pressure can predict adverse outcomes in patients with heart failure","volume":"12","author":"Taniguchi","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012115023147900_ehf213001-bib-0025","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1253\/circj.CJ-17-1344","article-title":"Prognostic relevance of liver stiffness assessed by transient elastography in patients with acute decompensated heart failure","volume":"82","author":"Saito","year":"2018","journal-title":"Circ J"},{"key":"2026012115023147900_ehf213001-bib-0026","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2017-000598","article-title":"Liver stiffness assessed by Fibrosis-4 index predicts mortality in patients with heart failure","volume":"4","author":"Sato","year":"2017","journal-title":"Open Heart"},{"key":"2026012115023147900_ehf213001-bib-0027","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1002\/ehf2.12222","article-title":"Liver fibrosis score predicts mortality in heart failure patients with preserved ejection fraction","volume":"5","author":"Yoshihisa","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2026012115023147900_ehf213001-bib-0028","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jcmg.2014.10.009","article-title":"Splenic metabolic activity predicts risk of future cardiovascular events: demonstration of a cardiosplenic axis in humans","volume":"8","author":"Emami","year":"2015","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012115023147900_ehf213001-bib-0029","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1161\/CIRCRESAHA.113.301720","article-title":"Remodeling of the mononuclear phagocyte network underlies chronic inflammation and disease progression in heart failure: critical importance of the cardiosplenic axis","volume":"114","author":"Ismahil","year":"2014","journal-title":"Circ Res"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/7\/6\/4005\/65902371\/eschf_7_6_4005.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/7\/6\/4005\/65902371\/eschf_7_6_4005.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T20:02:41Z","timestamp":1769025761000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/7\/6\/4005\/8372455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,13]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,9,13]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13001","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,9,13]]},"assertion":[{"value":"2020-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}