TỈ LỆ VÀ CÁC YẾU TỐ LIÊN QUAN ĐẾN TĂNG AMINITRANSFERASE Ở BỆNH NHÂN CAO TUỔI CÓ SUY TIM CẤP

Abstract

Objectives: Heart failure is a complex clinical syndrome characterized by reduced cardiac output or elevated intracardiac filling pressures at rest or during stress, leading to clinical symptoms such as dyspnea, fatigue, and edema. Hemodynamic changes in heart failure can result in end-organ damage. Abnormal liver function tests are not uncommon in heart failure patients, which can be a consequence of hypoperfusion or hepatic congestion due to increased right heart pressure, or secondary to drug toxicity. The clinical presentation of cardiac liver injury often resembles acute hepatitis, with a significant elevation in liver cell necrosis markers, including AST and ALT. Older adults are particularly susceptible, as they often have reduced organ function reserves due to age and comorbidities, leading to impaired compensatory responses to disease-related abnormalities. Therefore, the present study was conducted to investigate the prevalence of and factors associated with elevated aminotransferase levels in elderly HF patients with heart failure. Methods: This descriptive case series study enrolled patients aged ≥ 60 years who were diagnosed with heart failure at the Department of Internal Cardiology, Thong Nhat Hospital, and the Department of Internal Cardiology, University Medical Center, Ho Chi Minh City. Aminotransferase values were collected from the medical records. Factors associated with impairment were determined using logistic regression analysis. Results: The study enrolled 151 patients, with a mean AST level of 33.9 ± 23.1 U/L. 36.4% of patients had elevated AST levels. The mean ALT level was 25.1 ± 18.9 U/L, with 22.5% of patients having elevated ALT levels. Factors associated with elevated AST levels included widowhood (OR = 3.267; 95% CI, 1.345 - 7.938; p = 0.009). Older age (≥ 75 years) was an independent risk factor for elevated ALT levels (OR = 3.026; 95% CI, 1.301 - 7.036; p = 0.010). Conclusion: Elevated aminotransferases are common in elderly patients with heart failure. Widowhood and older age are independent risk factors for elevated aminotransferases in these patients. Further studies are needed to clarify the mechanism of this association and to identify interventions to improve the prognosis of elderly patients with heart failure.