Cumulative mean pulmonary artery pressure as a marker of hepatic congestion in patients with chronic heart failure

Patients with chronic heart failure (HF) are at increased risk of congestive hepatopathy, yet current clinical markers have limited predictive value. In this proof-of-concept study, we leveraged hemodynamic data from the CardioMEMS device to evaluate the association between pulmonary artery pressure and hepatic congestion, as assessed by MELD-XI score and abdominal imaging findings. We demonstrate that cumulative mean pulmonary artery pressure (mPAP) is associated with MELD-XI score, supporting the potential utility of longitudinal PAP monitoring in estimating hepatic dysfunction. The stronger association observed with cumulative mPAP, compared with cross-sectional measurements, suggests that persistent venous congestion over time may be more relevant to hepatic injury than single time-point value.