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Longitudinal Association of Non-Alcoholic Fatty Liver Disease With Changes in Myocardial Structure and Function: The

Lisa B VanWagner1,2, Jane E Wilcox2,3, Hongyan Ning2

  • 1Division of Gastroenterology & Hepatology Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL.

Journal of the American Heart Association
|February 19, 2020
PubMed

Insights

Non-alcoholic fatty liver disease (NAFLD) is linked to heart problems, including changes in heart structure and function over time. Obesity significantly contributes to this association, highlighting a key group for heart failure prevention.

Area of Science:

  • Cardiology
  • Hepatology
  • Epidemiology

Background:

  • Non-alcoholic fatty liver disease (NAFLD) is a significant risk factor for cardiovascular morbidity and mortality, particularly heart failure.
  • Left ventricular (LV) abnormalities in structure and function are established predictors of heart failure risk.

Purpose of the Study:

  • To investigate the association between NAFLD and subclinical changes in left ventricular (LV) structure and function over time.
  • To determine the role of obesity in mediating the relationship between NAFLD and cardiac abnormalities.

Main Methods:

  • Utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, including computed tomography for liver fat and serial echocardiography.
  • Classified NAFLD based on liver attenuation and assessed LV geometry, diastolic function, and systolic function (myocardial strain) at two time points.
  • Employed multivariable analyses to adjust for cardiovascular risk factors and the influence of body mass index.

Main Results:

  • Prevalence of NAFLD was 8.7% among participants.
  • NAFLD was associated with increased LV mass, relative wall thickness, incident LV hypertrophy, and abnormal LV geometry.
  • NAFLD participants exhibited impaired LV relaxation, higher filling pressures, worse longitudinal strain, and lower ejection fraction compared to non-NAFLD individuals.
  • NAFLD independently predicted incident LV hypertrophy, abnormal LV geometry, and greater changes in myocardial strain, but these associations were attenuated after adjusting for BMI.

Conclusions:

  • NAFLD is associated with progressive subclinical changes in left ventricular structure and function.
  • Obesity plays a substantial role in explaining the link between NAFLD and cardiac alterations.
  • Mid-life individuals with obesity and NAFLD represent a critical population for targeted heart failure prevention strategies.

Keywords:
NAFLDNASHheart failuremetabolic syndromeobesity

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