Liver stiffness measurement identifies subclinical myocardial dysfunction in non-advanced non-alcoholic fatty liver disease patients without overt heart disease

Patients with non-advanced non-alcoholic fatty liver disease (NAFLD) have an increased cardiovascular risk. The present study was designed to evaluate the relationship between liver stiffness measurement (LSM) by transient elastography (TE) and myocardial deformation indices of all cardiac chambers...

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Published in:Internal and emergency medicine 2022-08, Vol.17 (5), p.1425-1438
Main Authors: Sonaglioni, Andrea, Cerini, Federica, Cerrone, Antonio, Argiento, Lorenzo, Nicolosi, Gian Luigi, Rigamonti, Elisabetta, Lombardo, Michele, Rumi, Maria Grazia, Viganò, Mauro
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Language:English
Subjects:
Body mass index
Cardiovascular disease
Cardiovascular diseases
Coronary artery disease
Echocardiography
Fatty liver
Fibrosis
Heart diseases
Im - Original
Internal Medicine
Leukocytes (neutrophilic)
Liver diseases
Lymphocytes
Medicine
Medicine & Public Health
Ventricle
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container_title Internal and emergency medicine
container_volume 17
creator Sonaglioni, Andrea
Cerini, Federica
Cerrone, Antonio
Argiento, Lorenzo
Nicolosi, Gian Luigi
Rigamonti, Elisabetta
Lombardo, Michele
Rumi, Maria Grazia
Viganò, Mauro
description Patients with non-advanced non-alcoholic fatty liver disease (NAFLD) have an increased cardiovascular risk. The present study was designed to evaluate the relationship between liver stiffness measurement (LSM) by transient elastography (TE) and myocardial deformation indices of all cardiac chambers in NAFLD patients without overt heart disease. All consecutive NAFLD patients diagnosed with LSM 
doi_str_mv 10.1007/s11739-022-02966-2
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The present study was designed to evaluate the relationship between liver stiffness measurement (LSM) by transient elastography (TE) and myocardial deformation indices of all cardiac chambers in NAFLD patients without overt heart disease. All consecutive NAFLD patients diagnosed with LSM &lt; 12.5 kPa on TE between September 2021 and December 2021 entered the study. All participants underwent blood tests, TE and two-dimensional (2D) transthoracic echocardiography (TTE) implemented with speckle-tracking echocardiography (STE) analysis of left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS), right ventricular (RV) GLS, left atrial (LA) total global strain (TGSA) and right atrial (RA) TGSA. Main independent predictors of impaired LV-GLS (defined as absolute value less negative than − 20%) were evaluated. A total of 92 NAFLD patients (54.0 ± 11.1 years, 50% males) were prospectively analyzed. Mean LSM was 6.2 ± 2.4 kPa. Fibroscan results revealed that 76.1% of patients had F0-F1, 5.4% F2 and 18.5% F3 liver fibrosis. Despite normal biventricular systolic function on 2D-TTE, LV-GLS, LV-GCS and LV-GRS, RV-GLS, LA-TGSA and RA-TGSA were reduced in 64.1%, 38.0%, 38.0%, 31.5%, 39.1% and 41.3% of patients, respectively. Body mass index (BMI) (OR 1.76, 95% CI 1.18–2.64), neutrophil-to-lymphocyte ratio (NLR) (OR 4.93, 95% CI 1.15–31.8) and LSM (OR 9.26, 95% CI 2.24–38.3) were independently associated to impaired LV-GLS. BMI ≥ 29.3 kg/m 2 , NLR ≥ 1.8 and LSM ≥ 5.5 kPa were the best cut-off values for detecting outcome. LSM ≥ 5.5 kPa identifies NAFLD patients with subclinical myocardial dysfunction.</description><identifier>ISSN: 1828-0447</identifier><identifier>EISSN: 1970-9366</identifier><identifier>DOI: 10.1007/s11739-022-02966-2</identifier><identifier>PMID: 35302179</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Body mass index ; Cardiovascular disease ; Cardiovascular diseases ; Coronary artery disease ; Echocardiography ; Fatty liver ; Fibrosis ; Heart diseases ; Im - Original ; Internal Medicine ; Leukocytes (neutrophilic) ; Liver diseases ; Lymphocytes ; Medicine ; Medicine &amp; Public Health ; Ventricle</subject><ispartof>Internal and emergency medicine, 2022-08, Vol.17 (5), p.1425-1438</ispartof><rights>The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI) 2022</rights><rights>2022. 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The present study was designed to evaluate the relationship between liver stiffness measurement (LSM) by transient elastography (TE) and myocardial deformation indices of all cardiac chambers in NAFLD patients without overt heart disease. All consecutive NAFLD patients diagnosed with LSM &lt; 12.5 kPa on TE between September 2021 and December 2021 entered the study. All participants underwent blood tests, TE and two-dimensional (2D) transthoracic echocardiography (TTE) implemented with speckle-tracking echocardiography (STE) analysis of left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS), right ventricular (RV) GLS, left atrial (LA) total global strain (TGSA) and right atrial (RA) TGSA. Main independent predictors of impaired LV-GLS (defined as absolute value less negative than − 20%) were evaluated. A total of 92 NAFLD patients (54.0 ± 11.1 years, 50% males) were prospectively analyzed. Mean LSM was 6.2 ± 2.4 kPa. 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1970-9366
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source Springer Nature
subjects Body mass index
Cardiovascular disease
Cardiovascular diseases
Coronary artery disease
Echocardiography
Fatty liver
Fibrosis
Heart diseases
Im - Original
Internal Medicine
Leukocytes (neutrophilic)
Liver diseases
Lymphocytes
Medicine
Medicine & Public Health
Ventricle
title Liver stiffness measurement identifies subclinical myocardial dysfunction in non-advanced non-alcoholic fatty liver disease patients without overt heart disease
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