ALB and Decreased liver function: We found that the levels of aspartate aminotransferase (AST; p = 0.0052) and direct bilirubin (DBIL; p = 2e-05) were significantly higher in the NYHA class IV patients than those in the NYHA class II and III, whereas the level of albumin (ALB; p = 0.031) was lower (Fig. 3F), suggesting liver dysfunction in NYHA class IV patients of IE.