Efficacy of shear wave elastography for assessment of liver function in patients with heart failure

Aims Liver dysfunction is important for prognosis in heart failure (HF). Shear wave elastography (SWE), which is a novel ultrasound technique for charactering tissues, has been used in liver diseases. However, clinical implication of SWE, including dispersion slope, remains unknown in heart diseases. This study aimed to evaluate the efficacy of SWE assessing liver function in the severity of HF. Methods and results We enrolled 316 consecutive patients with or suspected heart diseases, who were classified according to the American College of Cardiology Foundation/American Heart Association stage of HF, including 37 with Stage A, 139 with Stage B, 114 with Stage C, and 26 with Stage D, and 45 normal subjects. Elasticity and dispersion slope of shear wave were assessed according to the HF stage. Elasticity and dispersion slope were not elevated in normal subjects and patients with Stage A. Elasticity was slightly increased from Stage A to Stage C and was remarkably elevated in Stage D (normal: 5.2 ± 1.1 kPa, Stage A: 5.4 ± 1.2 kPa, Stage B: 6.4 ± 1.8 kPa, Stage C: 7.8 ± 3.5 kPa, and Stage D: 17.7 ± 12.7 kPa), whereas dispersion slope was gradually increased from Stage A to Stage D (normal: 9.7 ± 1.7m/s/kHz, Stage A: 10.4 ± 1.6m/s/kHz, Stage B: 11.7 ± 2.4m/s/kHz, Stage C: 13.2 ± 3.4m/s/kHz, and Stage D: 17.6 ± 5.6 m/s/kHz). In the early HF stage, dispersion slope was elevated. In the advanced HF stage, both elasticity and dispersion slope were elevated. Liver function test abnormalities were observed only from Stage C or Stage D. Conclusions Dispersion slope could detect early liver damage, and the combination of elasticity and dispersion slope could clarify the progression of liver dysfunction in HF. SWE may be valuable to manage therapeutic strategies in patients with HF

Assessment of congestion and clinical outcomes in patients with chronic heart failure using shear wave elasticity

Aims The relief of congestion is essential for the prevention of worsening heart failure (HF) resulting in hospitalizations. Assessment of the degree of organ congestion in the chronic phase of HF is important for determining therapeutic strategies. The aim of this study was to evaluate the efficacy of shear wave (SW) elasticity for assessing congestion and clinical outcomes in patients with chronic HF. Methods and results We prospectively enrolled 345 consecutive patients with chronic HF who underwent SW elastography at outpatient clinic. Patients were divided into two groups according to the median value of SW elasticity: low group (SW elasticity = 6.4 kPa, n = 169). The endpoint was cardiovascular death or hospitalization for HF. During the median follow-up period of 19 months (range: 7-36 months), cardiovascular death or hospitalization for HF occurred in 4 patients of low group and 27 patients of high group. In high group, 8 patients died, and 19 patients were hospitalized for HF. In low group, 3 patients died, and 1 patient was hospitalized. Kaplan-Meier analysis showed that the event-free survival rate was worse in high group than in low group (log-rank test, P = 0.004). After adjusting for variables, high SW elasticity was independently related to cardiac events. In multivariate regression analysis, SW elasticity was correlated with left atrial volume index, early diastolic mitral inflow velocity to mitral annular velocity ratio, and inferior vena cava diameter. Conclusions The SW elasticity reflected haemodynamic congestion in patients with chronic HF, which was related to cardiac events

Baryon interactions from lattice QCD with physical quark masses -- Nuclear forces and ΞΞ\Xi\Xi forces --

We present the latest lattice QCD results for baryon interactions obtained at nearly physical quark masses. $N_f = 2+1$ nonperturbatively ${\cal O}(a)$-improved Wilson quark action with stout smearing and Iwasaki gauge action are employed on the lattice of (96a)^4 \simeq (8.1\mbox{fm})^4 with $a^{-1} \simeq 2.3$ GeV, where $m_\pi \simeq 146$ MeV and $m_K \simeq 525$ MeV. In this report, we study the two-nucleon systems and two-$\Xi$ systems in $^1S_0$ channel and $^3S_1$-$^3D_1$ coupled channel, and extract central and tensor interactions by the HAL QCD method. We also present the results for the $N\Omega$ interaction in $^5S_2$ channel which is relevant to the $N\Omega$ pair-momentum correlation in heavy-ion collision experiments.Comment: Talk given at 35th International Symposium on Lattice Field Theory (Lattice 2017), Granada, Spain, 18-24 Jun 2017, 8 pages, 9 figures. arXiv admin note: text overlap with arXiv:1702.0160

Most Strange Dibaryon from Lattice QCD

The $\Omega\Omega$ system in the $^1S_0$ channel (the most strange dibaryon) is studied on the basis of the (2+1)-flavor lattice QCD simulations with a large volume (8.1 fm)$^3$ and nearly physical pion mass $m_{\pi}\simeq 146$ MeV at a lattice spacing $a\simeq 0.0846$ fm. We show that lattice QCD data analysis by the HAL QCD method leads to the scattering length $a_0 = 4.6 (6)(^{+1.2}_{-0.5}) {\rm fm}$, the effective range $r_{\rm eff} = 1.27 (3)(^{+0.06}_{-0.03}) {\rm fm}$ and the binding energy $B_{\Omega \Omega} = 1.6 (6) (^{+0.7}_{-0.6}) {\rm MeV}$. These results indicate that the $\Omega\Omega$ system has an overall attraction and is located near the unitary regime. Such a system can be best searched experimentally by the pair-momentum correlation in relativistic heavy-ion collisions.Comment: 6 pages and 4 figure

NΩN\Omega dibaryon from lattice QCD near the physical point

The nucleon($N$)-Omega($\Omega$) system in the S-wave and spin-2 channel ($^5$S$_2$) is studied from the (2+1)-flavor lattice QCD with nearly physical quark masses ($m_\pi \simeq 146$~MeV and $m_K \simeq 525$~MeV). The time-dependent HAL QCD method is employed to convert the lattice QCD data of the two-baryon correlation function to the baryon-baryon potential and eventually to the scattering observables. The $N\Omega$($^5$S$_2$) potential, obtained under the assumption that its couplings to the D-wave octet-baryon pairs are small, is found to be attractive in all distances and to produce a quasi-bound state near unitarity: In this channel, the scattering length, the effective range and the binding energy from QCD alone read $a_0= 5.30(0.44)(^{+0.16}_{-0.01})$~fm, $r_{\rm eff} = 1.26(0.01)(^{+0.02}_{-0.01})$~fm, $B = 1.54(0.30)(^{+0.04}_{-0.10})$~MeV, respectively. Including the extra Coulomb attraction, the binding energy of $p\Omega^-$($^5$S$_2$) becomes $B_{p\Omega^-} = 2.46(0.34)(^{+0.04}_{-0.11})$~MeV. Such a spin-2 $p\Omega^-$ state could be searched through two-particle correlations in $p$-$p$, $p$-nucleus and nucleus-nucleus collisions.Comment: 16 pages, 6 figures, a reference adde