Abnormal liver function tests are common in ambulatory chronic heart failure but characterization and importance of liver dysfunction are poorly defined.

The aim of this study was to evaluate the incidence of liver dysfuction in ambulatory patients diagnosed with chronic heart failure in order to establish a correlation with the risk factors, evolution and prognosis.

1613 consecutive ambulatory patients with chronic heart failure were enrolled from 2006 to 2013 and registered in the therapeutic unit of chronic heart failure. Clinical, echocardiographic and biological data were investigated.

In only 358 HF patients, liver function was determined by aspartate and alanine aminotransferase (AST, ALT). We divided our population into three groups: group 1 with elevated ALT>45 UI/l, group 2 with elevated AST>45 UI/l and group 3 with normal liver enzymes.

Liver dysfunction was present in 13.68%. Mean serum levels of ALT and AST were 98.44 UI/l and 88.43 UI/l respectively. Liver dysfunction was associated with male sex (p=0.019), dyslipidemia, smoker and coronary heart disease (p=0.004). Compared with a normal liver function, those with dysfunction had a higher heart rate and more cardiac right and left decompensation. Also Transaminases elevated were associated with more tricuspid regurgitation (p<0.00001), pulmonary hypertension (p<0.00026), right ventricular dysfunction (p=0.02), kidney dysfunction (DFG<60mL/min/mm³) (p=0.018), higher doses of diuretics (p<0.02), whereas beta-blockers were inversely associated (P<0.0001). No correlation between liver function and using statins and spironolactone was found (p=0.8 and 0.1 respectively).

Liver dysfunction is frequent in chronic heart failure. Patients with heart failure and abnormal liver function had less optimized traitment with more hospitalizations for cardiac decompensation