The Fibrosis-4 (FIB4) index could indicate the liver fibrosis in patients with chronic hepatic diseases. It was calculated using the following formula: (age × aspartate aminotransferase [U/L]) / (platelet count [10³/μL] × √alanine aminotransferase [U/L]). However, the clinical impact of the FIB4 index in the acute phase of acute heart failure (AHF) has not been sufficiently investigated.

A total 1,468 AHF patients were analyzed. The median FIB4 index was 2.71 [1.85-4.22]. The patients were divided into three groups according to the quartiles of their FIB4 index (low-FIB4 [Q1, ≤ 1.847], middle-FIB4 [Q2/Q3, 1.848-4.216], and high-FIB4 [Q4, ≥ 4.216] groups). A Kaplan-Meier curve analysis showed that the prognosis, such as all-cause mortality and HF events within 365 days, was significantly poorer in the high-FIB4 group than in the middle-FIB4 and low-FIB4 groups. A multivariate Cox regression model identified high FIB4 index as an independent predictor of 365-day all-cause death (hazard ratio (HR): 1.660, 95% CI: 1.136-2.427) and HF events (HR: 1.505, 95% CI: 1.145-1.978). The multivariate logistic regression analysis showed that the high plasma volume status (PVS) (Q4, odds ratio [OR]: 2.099, 95% CI: 1.429-3.082), low systolic blood pressure (SBP) (< 100 mmHg, OR: 3.825, 95% CI: 2.504-5.840), and low left ventricular ejection fraction (< 40%, OR: 1.321, 95% CI: 1.002-1.741) were associated with a high FIB4 index.

A high FIB4 index can predict adverse outcomes in AHF patients, which indicate that congestive liver and liver hypoperfusion occur due to low cardiac output in the acute phase of AHF.

Fibrosis-4（FIB4）指数可以指示慢性肝病患者的肝纤维化。使用以下公式计算：（年龄×天冬氨酸氨基转移酶[U/L]）/（血小板计数[10 ³ /μL]×√丙氨酸氨基转移酶[U/L]）。然而，FIB4 指数在急性心力衰竭 (AHF) 急性期的临床影响尚未得到充分研究。

共分析了 1,468 名 AHF 患者。FIB4 指数中位数为 2.71 [1.85-4.22]。根据 FIB4 指数的四分位数将患者分为三组（低 FIB4 [Q1，≤ 1.847]、中 FIB4 [Q2/Q3，1.848-4.216] 和高 FIB4 [Q4，≥ 4.216] 组）。Kaplan-Meier 曲线分析显示，高 FIB4 组的预后，例如全因死亡率和 365 天内的 HF 事件，明显低于中 FIB4 和低 FIB4 组。多变量 Cox 回归模型将高 FIB4 指数确定为 365 天全因死亡（风险比 (HR)：1.660，95% CI：1.136-2.427）和 HF 事件（HR：1.505，95% CI： 1.145-1.978）。多变量逻辑回归分析显示高血浆容量状态（PVS）（Q4，优势比[OR]：2.099，95% CI：1.429-3.082），

高 FIB4 指数可以预测 AHF 患者的不良结果，这表明 AHF 急性期由于低心输出量而发生充血性肝脏和肝脏低灌注。