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. 2022 Jan 6;4(4):166-172.
doi: 10.1253/circrep.CR-21-0155. eCollection 2022 Apr 8.

Gallbladder Wall Thickness-Based Assessment of Organ Congestion in Patients With Heart Failure

Takahiro Sakamoto  1   2 , Kazuhiko Uchida  2 , Akihiro Endo  1 , Hiroyuki Yoshitomi  3 , Kazuaki Tanabe  1
Affiliations

Gallbladder Wall Thickness-Based Assessment of Organ Congestion in Patients With Heart Failure

Takahiro Sakamoto et al. Circ Rep. .

Abstract

Background: Diffuse gallbladder (GB) wall thickening is caused by elevated systemic venous pressure, such as heart failure (HF). This study investigated the relationship between GB wall thickness (WT) and HF, and the prognostic impact of GBWT. Methods and Results: This prospective study included 116 patients with HF and 11 healthy controls. Among the 116 patients, 30 with GBWT measurements in the postprandial state or a history and/or signs of GB disease were excluded. The remaining 86 patients had significantly higher GBWT than the controls (median [interquartile range {IQR}] 2.0 [1.7-2.4] vs. 1.3 [1.1-1.6] mm, respectively; P<0.001). GBWT was significantly correlated with B-type natriuretic peptide (r=0.386, P<0.001), left atrial volume index (r=0.452, P<0.001), and tricuspid annular plane systolic excursion (r=-0.311, P=0.006). GBWT also exhibited a stepwise increasing relationship with increasing HF stage (Stage B, 22 patients, median [IQR] 1.8 [1.7-2.1] mm; Stage C, 60 patients, 2.0 [1.8-2.5] mm; and Stage D, 4 patients: 4.0 [3.5-4.5] mm). In Stage C or D HF patients, 11 hospitalizations for HF were observed over a median follow-up of 303 days (IQR 125-394 days). Furthermore, the rate of hospitalization events for HF was significantly higher in the high (≥3 mm) than low GBWT group (P=0.007). Conclusions: GBWT can be used to assess organ congestion in patients with HF.

Keywords: Gallbladder wall; Heart failure; Organ congestion; Ultrasonography.

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Conflict of interest statement

K.T. is a member of Circulation Reports’ Editorial Team. The other authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Gallbladder wall thickness measured using a sector scan in a patient in the supine position after echocardiography. Measurements of the (A) normal gallbladder wall and (B) diffuse gallbladder wall thickening are noted.
Figure 2.
Figure 2.
Gallbladder (GB) wall thickness in the control and heart failure (HF) groups. The boxes show the interquartile range, with the median value indicated by the horizontal line; whiskers show the range.
Figure 3.
Figure 3.
(A,B) Gallbladder (GB) wall thickness according to heart failure (HF) stage (A) and B-type natriuretic peptide (BNP) tertiles (B). (C) GB wall thickness in patients with no hospitalizations and those with ≥2 hospitalizations in 1 year. The boxes show the interquartile range, with the median value indicated by the horizontal line; whiskers show the range.
Figure 4.
Figure 4.
Kaplan-Meier plot of event-free (hospitalization for heart failure) survival in patients in high (≥3 mm) and low gallbladder (GB) wall thickness.
See this image and copyright information in PMC

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