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How Cardiac Fibrosis Assessed via T1 Mapping Is Associated with Liver Fibrosis in Patients with Non-Alcoholic Fatty
Flavia Vernin de Oliveira Terzi1, Gabriel Cordeiro Camargo1, Daniella Braz Parente1,2
1D'Or Institute for Research and Education-IDOR, Rio de Janeiro 22281-100, Brazil.
Insights
Nonalcoholic fatty liver disease (NAFLD) is linked to heart problems. Patients with significant liver fibrosis showed more diffuse myocardial fibrosis, indicating a connection between liver and heart scarring.
Area of Science:
- Cardiology
- Hepatology
- Radiology
Background:
- Nonalcoholic fatty liver disease (NAFLD) is a prevalent global liver condition.
- Overlapping risk factors exist between cardiovascular disease and NAFLD.
- The correlation between hepatic and cardiac fibrosis in NAFLD patients requires further investigation.
Purpose of the Study:
- To assess myocardial fibrosis in NAFLD patients.
- To correlate myocardial fibrosis with liver fibrosis severity in NAFLD.
Main Methods:
- Cross-sectional study of NAFLD patients categorized by liver fibrosis stage (F0-F1 vs. F2-F4) via MRI.
- Evaluation of cardiovascular risk factors using Framingham risk scores.
- Multiparametric cardiac and abdominal MRI assessments.
Main Results:
- Patients with significant liver fibrosis had higher calcium scores and increased myocardial extracellular volume (ECV).
- A significant correlation was found between liver fibrosis and cardiac fibrosis (ECV) (r = 0.49, p < 0.001).
- Myocardial ECV effectively differentiated patients with and without significant liver fibrosis (AUC = 0.78).
Conclusions:
- Diffuse myocardial fibrosis is associated with liver fibrosis in NAFLD patients.
- This association highlights a potential link between liver and heart conditions in NAFLD.
Abstract:
(1) Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. Although cardiovascular and NAFLD risk factors overlap, an independent association between these conditions may exist. Hepatic and cardiac fibrosis are important markers of mortality, but the correlation between these markers in patients with NAFLD has not been well studied. Our main objective was to determine the degree of myocardial fibrosis in patients with NAFLD and its correlation with the severity of liver fibrosis. (2) Methods: In this cross-sectional study, patients with NAFLD were allocated to two groups according to the stage of liver fibrosis assessed using MRI: no or mild fibrosis (F0-F1) and significant fibrosis (F2-F4). Framingham risk scores were calculated to evaluate cardiovascular risk factors, and patients underwent multiparametric cardiac and abdominal MRIs. (3) Results: The sample comprised 44 patients (28 with no or mild liver fibrosis and 16 with significant liver fibrosis). The mean age was 57.9 ± 12 years, and 41% were men. Most patients had high cardiac risk factors and carotid disease. Relative to patients with no or mild liver fibrosis, those with significant fibrosis had a higher median calcium score (p = 0.05) and increased myocardial extracellular volume (ECV; p = 0.02). Liver fibrosis correlated with cardiac fibrosis, represented by the ECV (r = 0.49, p < 0.001). The myocardial ECV differentiated patients with and without significant liver fibrosis (AUC = 0.78). (4) Conclusion: This study showed that diffuse myocardial fibrosis is associated with liver fibrosis in patients with NAFLD.
