Multiple echocardiographic indices of right heart dysfunction and low cardiac index are related to elevated total bilirubin, according to research published in the Journal of the American Society of Echocardiography.

Patients with heart failure frequently report elevated total bilirubin and transaminases, which can be linked to a poor prognosis. Grzegorz Styczyński, MD, PhD, of the Medical University of Warsaw Department of Internal Medicine, Hypertension, and Angiology, and colleagues, aimed to evaluate the correlation between echocardiography and elevated total bilirubin and transaminases in patients with exacerbated chronic heart failure.

In a prospective study of 150 patients, the researchers measured a number of echocardiographic markers, including right ventricular end-diastolic diameter, right atrial area, tricuspid regurgitation, right ventricular systolic pressure, tricuspid annular plane systolic excursion, tricuspid lateral annulus systolic velocity, estimated right atrial pressure, portal vein pulsatility index (PVPI), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction, and cardiac index.

Continue Reading

“Elevated total bilirubin was found in 61 patients (41%) and elevated transaminases in 46 patients (31%),” wrote Dr. Styczyński and colleagues. “In a multivariate regression model, only PVPI remained a significant predictor of elevated total bilirubin and LVEDD indexed to body surface area of elevated transaminases.”

A weak statistically significant association was found between elevated transaminase levels and LVEDD indexed to body surface area.


  1. Styczyński G, Milewska A, Marczewska M. Echocardiographic correlates of abnormal liver tests in patients with exacerbation of chronic heart failure. J Am Soc Echocardiogr. 2015; doi: 10.1016/j.echo.2015.09.012