{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:48:36Z","timestamp":1788749316379,"version":"build-2803163510"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Interdisciplinary Center of Clinical Research\u2014IZKF, W\u00fcrzburg","award":["2018\u20132021"],"award-info":[{"award-number":["2018\u20132021"]}]},{"name":"Interdisciplinary Center of Clinical Research\u2014IZKF, W\u00fcrzburg","award":["Z-2_CSP-08"],"award-info":[{"award-number":["Z-2_CSP-08"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Congestion is associated with poor prognosis in cardiac amyloidosis (CA). The cardio-hepatic interaction and the prognostic impact of secondary liver affection by cardiac congestion in CA are poorly understood and require further characterisation. Methods: Participants of the amyloidosis cohort study AmyKoS at the Interdisciplinary Amyloidosis Centre of Northern Bavaria with proven transthyretin (ATTR-CA) and light chain CA (AL-CA) underwent serial work-up including laboratory tests, echocardiography, and in-depth hepatic assessment by vibration-controlled transient elastography (VCTE) and 13C-methacetin breath test. Results: In total, 74 patients with AL-CA (n = 17), ATTR-CA (n = 26) and the controls (n = 31) were analysed. ATTR-CA patients showed decreased microsomal liver function expressed by maximal percentage of dose rate (PDRpeak) related to hepatic congestion. Reduced PDRpeak in AL-CA could result from altered pharmacokinetics due to changed hepatic blood flow. Liver stiffness as a combined surrogate of chronic liver damage and congestion was identified as a predictor of all-cause mortality. Statistical modelling of the cardio-hepatic interaction revealed septum thickness, NT-proBNP and PDRpeak as predictors of liver stiffness in both CA subtypes; dilatation of liver veins and the fibrosis score FIB-4 were only significant for ATTR-CA. Conclusions: Non-invasive methods allow us to characterise CA-associated hepatic pathophysiology. Liver stiffness might be promising for risk stratification in CA.<\/jats:p>","DOI":"10.3390\/jcm13051440","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T11:19:24Z","timestamp":1709291964000},"page":"1440","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cardio-Hepatic Interaction in Cardiac Amyloidosis"],"prefix":"10.3390","volume":"13","author":[{"given":"Sandra Michaela","family":"Ihne-Schubert","sequence":"first","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine II, Hematology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"CIRCLE\u2014Centre for Innovation Research, Lund University, 22100 Lund, Sweden"},{"name":"Department of Internal Medicine IV, University Hospital Gie\u00dfen and Marburg, 35392 Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Goetze","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine II, Hepatology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Medicine, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum, 44892 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Gerstend\u00f6rfer","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine II, Hematology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2033-9354","authenticated-orcid":false,"given":"Floran","family":"Sahiti","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Comprehensive Heart Failure Center, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine I, Cardiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Schade","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Thoracic Endoscopy, Helios Klinikum Erfurt, 99089 Erfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9584-0632","authenticated-orcid":false,"given":"Aikaterini","family":"Papagianni","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Neurology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0920-6094","authenticated-orcid":false,"given":"Caroline","family":"Morbach","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Comprehensive Heart Failure Center, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine I, Cardiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Frantz","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Comprehensive Heart Failure Center, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine I, Cardiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7680-0819","authenticated-orcid":false,"given":"Hermann","family":"Einsele","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine II, Hematology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Knop","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine II, Hematology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine V, Hospital N\u00fcrnberg Nord, 90419 N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Sommer","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern Bavaria, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Neurology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9020-8192","authenticated-orcid":false,"given":"Beat","family":"M\u00fcllhaupt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9546-880X","authenticated-orcid":false,"given":"Torben","family":"Schubert","sequence":"additional","affiliation":[{"name":"CIRCLE\u2014Centre for Innovation Research, Lund University, 22100 Lund, Sweden"},{"name":"Fraunhofer Institute for Systems and Innovation Research ISI, 76139 Karlsruhe, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1771-7249","authenticated-orcid":false,"given":"Stefan","family":"St\u00f6rk","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center of Northern 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