NAFLD in Cardiovascular Diseases: A Contributor or Comorbidity?

Area of Science:

• Cardiology
• Hepatology
• Metabolic Syndrome

Background:

• Nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVDs) are globally prevalent and increasingly recognized as associated conditions.
• Emerging evidence links NAFLD to various cardiovascular manifestations, including coronary artery disease, cardiac remodeling, and stroke.

Approach:

• This review synthesizes findings from longitudinal and cross-sectional studies examining the association between NAFLD and cardiovascular outcomes.
• It explores potential underlying mechanisms, such as metabolic syndrome acting as a shared upstream defect.
• Current management strategies for NAFLD and their implications for cardiovascular health are discussed.

Key Points:

• NAFLD is associated with coronary artery disease, cardiac remodeling, aortic valve calcifications, diabetic cardiomyopathy, diastolic dysfunction, arrhythmias, and stroke.
• Metabolic syndrome is a proposed unifying mechanism linking liver and heart pathology.
• Weight loss, lifestyle changes, bariatric surgery, and targeted pharmacological interventions are key management strategies for NAFLD.

Conclusions:

• While specific NAFLD therapies targeting fibrosis or steatohepatitis are emerging, their impact on cardiovascular outcomes requires further investigation.
• A multidisciplinary approach is crucial for optimizing the diagnosis and management of patients with co-existing NAFLD and CVDs.
• Addressing cardiovascular risks is paramount, as CVDs represent the leading cause of mortality in NAFLD patients.