Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) encompasses a range of diseases from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) and has been linked to cardiovascular disease and sub-clinical cardiac remodeling. This paper presents a retrospective study of biop...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jin Publishing & Printing Co.
2022-09-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | https://www.kjg.or.kr/journal/view.html?uid=5745&vmd=Full |
| _version_ | 1818017282546204672 |
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| author | Peter C. Johnson Anthony A. Cochet Rosco S. Gore Stephen A. Harrison John P. Magulick James K. Aden Angelo H.Paredes |
| author_facet | Peter C. Johnson Anthony A. Cochet Rosco S. Gore Stephen A. Harrison John P. Magulick James K. Aden Angelo H.Paredes |
| author_sort | Peter C. Johnson |
| collection | DOAJ |
| description | Background/Aims: Nonalcoholic fatty liver disease (NAFLD) encompasses a range of diseases from nonalcoholic fatty liver (NAFL)
to nonalcoholic steatohepatitis (NASH) and has been linked to cardiovascular disease and sub-clinical cardiac remodeling. This paper
presents a retrospective study of biopsy-proven NAFL and NASH to examine the differences in subclinical cardiac remodeling.
Methods: Patients were recruited from an institutional repository of patients with liver-biopsy-confirmed NAFLD. Patients with a transthoracic
echocardiogram (TTE) within 12 months of the liver biopsy were included. The parameters of the diastolic dysfunction were
reviewed for the differences between NAFL and NASH as well as between the stages and grades of NASH.
Results: Thirty-three patients were included in the study, 17 with NAFL and 16 with NASH. The NASH patients were more likely to have
lower platelets, higher AST, higher ALT, and higher rates of type 2 diabetes mellitus, coronary artery disease, and hypertension than
the NAFL patients. The E/e’ ratio on transthoracic echocardiogram was significantly higher in NASH compared to NAFL, advanced-stage
NASH compared to early stage, and high-grade NASH compared to low-grade. The E/e’ ratio was also significantly higher in NASH
than NAFL in patients without diabetes mellitus. The presence of diastolic dysfunction trended toward significance. The other markers
of diastolic dysfunction were similar. Logistic regression revealed a statistical association with E/e' and NASH.
Conclusions: NASH patients had evidence of a higher E/e’ ratio than NAFL, and there was a trend towards a significant diastolic
dysfunction. Patients with NASH compared to NAFL should be closely monitored for signs and symptoms of cardiac dysfunction. |
| first_indexed | 2024-04-14T07:24:08Z |
| format | Article |
| id | doaj.art-081ce2e5b28d411ca9db977ee170c3a4 |
| institution | Directory Open Access Journal |
| issn | 1598-9992 2233-6869 |
| language | English |
| last_indexed | 2024-04-14T07:24:08Z |
| publishDate | 2022-09-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-081ce2e5b28d411ca9db977ee170c3a42022-12-22T02:06:03ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692022-09-0178316116710.4166/kjg.2021.040Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver DiseasePeter C. Johnson0https://orcid.org/0000-0003-4466-3052Anthony A. Cochet1Rosco S. Gore2Stephen A. Harrison3John P. Magulick4James K. Aden5Angelo H.Paredes6Department of Medicine, Brooke Army Medical Center, San Antonio, TX; Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USADepartment of Medicine, Cardiology Service, Brooke Army Medical Center3, San Antonio, TX, USADepartment of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD; Department of Medicine, Cardiology Service, Brooke Army Medical Center, San Antonio, TX, USAPinnacle Clinical Research, San Antonio, TX, USADepartment of Medicine, Gastroenterology and Hepatology Service, Brooke Army Medical Center, TX, USADepartment of Medicine, US Army Institute for Surgical Research, San Antonio, TX, USADepartment of Medicine, Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD; Department of Medicine, Cardiology Service, Brooke Army Medical Center, San Antonio, TX, USABackground/Aims: Nonalcoholic fatty liver disease (NAFLD) encompasses a range of diseases from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) and has been linked to cardiovascular disease and sub-clinical cardiac remodeling. This paper presents a retrospective study of biopsy-proven NAFL and NASH to examine the differences in subclinical cardiac remodeling. Methods: Patients were recruited from an institutional repository of patients with liver-biopsy-confirmed NAFLD. Patients with a transthoracic echocardiogram (TTE) within 12 months of the liver biopsy were included. The parameters of the diastolic dysfunction were reviewed for the differences between NAFL and NASH as well as between the stages and grades of NASH. Results: Thirty-three patients were included in the study, 17 with NAFL and 16 with NASH. The NASH patients were more likely to have lower platelets, higher AST, higher ALT, and higher rates of type 2 diabetes mellitus, coronary artery disease, and hypertension than the NAFL patients. The E/e’ ratio on transthoracic echocardiogram was significantly higher in NASH compared to NAFL, advanced-stage NASH compared to early stage, and high-grade NASH compared to low-grade. The E/e’ ratio was also significantly higher in NASH than NAFL in patients without diabetes mellitus. The presence of diastolic dysfunction trended toward significance. The other markers of diastolic dysfunction were similar. Logistic regression revealed a statistical association with E/e' and NASH. Conclusions: NASH patients had evidence of a higher E/e’ ratio than NAFL, and there was a trend towards a significant diastolic dysfunction. Patients with NASH compared to NAFL should be closely monitored for signs and symptoms of cardiac dysfunction.https://www.kjg.or.kr/journal/view.html?uid=5745&vmd=Fullnon-alcoholic fatty liver diseasesteatohepatitisdiastolic heart failurecardiac diseases |
| spellingShingle | Peter C. Johnson Anthony A. Cochet Rosco S. Gore Stephen A. Harrison John P. Magulick James K. Aden Angelo H.Paredes Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease The Korean Journal of Gastroenterology non-alcoholic fatty liver disease steatohepatitis diastolic heart failure cardiac diseases |
| title | Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease |
| title_full | Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease |
| title_fullStr | Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease |
| title_full_unstemmed | Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease |
| title_short | Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease |
| title_sort | early cardiac dysfunction in biopsy proven nonalcoholic fatty liver disease |
| topic | non-alcoholic fatty liver disease steatohepatitis diastolic heart failure cardiac diseases |
| url | https://www.kjg.or.kr/journal/view.html?uid=5745&vmd=Full |
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