Association of non-alcoholic fatty liver disease with cardiac structural impairment

Česká verzia

Authors: Demková K. ¹; Jr Varga T. ²; Tokarčík J. ¹
Authors place of work: IV. interná klinika LF UPJŠ a UN L. Pasteura Košice ¹; INTERNÉ – MUDr. VARGOVÁ T., s. r. o., Kráľovský Chlmec ²
Published in the journal: Gastroent Hepatol 2022; 76(4): 341-346
Category:
doi: https://doi.org/10.48095/ccgh2022341

Summary

Non-alcoholic fatty liver disease encompasses a spectrum of pathologic entities ranging from liver steatosis through non-alcoholic steatohepatitis and fibrosis to cirrhosis of the liver. Patients with non-alcoholic fatty liver disease have a higher incidence of coronary artery disease, cardiovascular events due to atherosclerosis, both ischemic and haemorrhagic strokes, thromboembolic events, conduction system disorders, left ventricular dysfunction, and also cardiovascular mortality. Non-alcoholic fatty liver disease is also associated with structural abnormalities of the myocardium and valves. Non-alcoholic steatohepatitis develops in about 8–20% of obese patients with simple hepatic steatosis. The disease tends to progress and may be poorly controlled therapeutically. Non-alcoholic steatohepatitis increases the risk of mortality from cardiovascular disease by 2.1-fold and the risk of mortality from any cause by 2.3-fold. The inflammatory process in the liver may represent a major determinant of systemic complications in people with non-alcoholic fatty liver disease, so its assessment could be useful for cardiovascular risk assessment. Due to the documented association between the severity of hepatic steatosis assessed by ultrasonography and coronary or carotid atherosclerosis, ultrasonographic examination of the liver may be helpful in identifying people at high cardiovascular risk. The present case report confirms the importance of echocardiographic screening for structural and functional cardiac abnormalities in patients with chronic non-alcoholic steatohepatitis in order to initiate early treatment and improve their prognosis.

Keywords:

echocardiography – screening – non-alcoholic fatty liver disease – ultrasonography

Zdroje

1. Češka R. Interna. Praha: Triton 2020.

2. Ehrmann J. Ikterus – diferenciální diagnostika. Praha: Grada Publishing a. s. 2003.

3. Hrušovský Š. Praktická hepatológia. Bratislava: Vydavateľstvo zdravotníckej literatúry HERBA, spol. s. r. o. 2015.

4. Vonghia L, Magrone T, Verrijken A et al. Peripheral and hepatic vein cytokine levels in correlation with non-alcoholic fatty liver disease (NAFLD) – related metabolic, histological, and haemodynamic features. PLoS One 2015; 10 (11): e0143380. doi: 10.1371/journal.pone.0143 380.

5. Tana C, Ballestri S, Ricci F et al. Cardiovascular risk in non-alcoholic fatty liver disease: mechanisms and therapeutic implications. Int J Environ Res Public Health 2019; 16 (17): 3104. doi: 10.3390/ijerph16173104.

6. Targher G, Bertolini L, Rodella S et al. Nonalcoholic fatty liver disease is independently associated with an increased incidence of cardiovascular events in type 2 diabetic patients. Diabetes Care 2007; 30 (8): 2119–2121. doi: 10.2337/dc07-0349.

7. Mantovani A, Zoppini G, Targher G et al. Non-alcoholic fatty liver disease is independently associated with left ventricular hypertrophy in hypertensive type 2 diabetic individuals. J Endocrinol Investig 2012; 35 (2): 215–218. doi: 10.1007/BF03345421.

8. Mantovani A, Pernigo M, Bergamini C et al. Nonalcoholic fatty liver disease is independently associated with early left ventricular diastolic dysfunction in patients with type 2 diabetes. PLoS One 2015; 10 (8): 1–13. doi: 10.1371/journal.pone.0135329.

9. VanWagner LB, Wilcox JE, Colangelo LA et al. Association of nonalcoholic fatty liver disease with subclinical myocardial remodeling and dysfunction: a population-based study. Hepatology 2015; 62 (3): 773–783. doi: 10.1002/hep.27869.

10. Markus MR, Baumeister SE, Stritzke J et al. Hepatic steatosis is associated with aortic valve sclerosis in the general population: The Study of Health in Pomerania (SHIP). Arterioscler Thromb Vasc Biol 2013; 33 (7): 1690–1695. doi: 10.1161/ATVBAHA.112.300556.

11. Bonapace S, Valbusa F, Bertolini L et al. Nonalcoholic fatty liver disease is associated with aortic valve sclerosis in patients with type 2 diabetes mellitus. PLoS One 2014; 9 (2): e88371. doi: 10.1371/journal.pone.0088371.

12. Valbusa F, Agnoletti D, Scala L et al. Non-alcoholic fatty liver disease and increased risk of all-cause mortality in elderly patients admitted for acute heart failure. Int J Cardiol 2018; 265: 162–168. doi: 10.1016/j.ijcard.2018.04.129.

13. Pereira ENGDS, Silvares RR, Flores EEI et al. Hepatic microvascular dysfunction and increased advanced glycation end products are components of non-alcoholic fatty liver disease. PLoS One 2017; 12 (6): e0179654. doi: 10.1371/journal.pone.0179654.

14. Simon TG, Bamira DG, Chung RT et al. Nonalcoholic steatohepatitis (NASH) is associated with cardiac remodeling and dysfunction. Obesity 2017; 25 (8): 1313–1316. doi: 10.1002/oby.21879.

15. Ballestri S, Romagnoli D, Nascimbeni F et al. Role of ultrasound in the diagnosis and treatment of nonalcoholic fatty liver disease and its complications. Expert Rev Gastroenterol Hepatol 2015; 9 (5): 603–627. doi: 10.1586/ 17474124.2015.1007955.

16. Fedelešová M, Kupčová V, Szántová M et al. Možnosti použitia neinvazívnych metód pri nealkoholovej tukovej chorobe pečene. Gastroent Hepatol 2017; 71 (4): 325–332. doi: 10.14735/amgh2017325.