Features of diagnostics of liver fibrosis and steatosis in patients with diffuse liver diseases, metabolic syndrome and heart failure

Objective. To evaluate the potential of comprehensive multiparametric ultrasound examination for screening and monitoring comorbid pathology in patients with metabolic syndrome, chronic diffuse liver diseases, and heart failure.

Materials and methods. Between 2023 and 2024, a total of 84 patients undergoing treatment in cardiology and gastroenterology departments were examined. The main study group included individuals with overweight (BMI >25), signs of metabolic syndrome with confirmed liver steatosis, non-alcoholic steatohepatitis, or other diffuse liver diseases. The patients underwent general and biochemical blood tests, lipid profile analysis, abdominal ultrasound, transient elastography, dual-energy X-ray absorptiometry in «Whole Body» mode to assess abdominal fat structure, quantitative ultrasound liver steatometry, and transthoracic echocardiography in 44 patients. The control group (n=40) consisted of healthy individuals.

Results. In the study group, elevated liver transaminases were observed. Elastography revealed predominant values in the F2–F3 range, indicative of venous congestion of the liver (in combination with ultrasound signs) and/or the development of clinically significant fibrosis. According to quantitative ultrasound steatometry, patients with liver steatosis values in the S1–S2 and S2–S3 ranges were equally frequent, although a slight predominance of S1–S2 (clinically insignificant steatosis) was noted. Moderate structural and functional myocardial abnormalities were detected in both groups.

Conclusions. Multiparametric ultrasound examination of the liver is a crucial method for diagnosing and monitoring comorbid pathology in patients with diffuse liver diseases, metabolic syndrome, and heart failure. It enables early detection and assessment of liver steatosis and fibrosis, providing quantitative data that correlate with histological findings from liver biopsy specimens.

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