Association between Nonalcoholic Fatty Liver Disease on CT and Myocardial Infarct Size using SPECT-MPI in patients with ST-elevation Myocardial Infarction

Abstract

Background: We aim to explore the association between nonalcoholic fatty liver disease (NAFLD), intrathoracic fat (IF), pericardial fat (PF) and myocardial infarct size (MIS) in patients with ST-elevation myocardial infarction (STEMI). Methods: SPECT-MPI was used to detect MIS, while CT scans were used to measure IF, PF, and NAFLD in patients with STEMI. Firstly, we categorised the patients into two groups (those with measurable and nonmeasurable MIS). The difference in fat between the two groups was compared using a two-sample t-test to determine which type of fat might be correlated with MIS. Secondly, the association between the related fats obtained in the aforementioned steps and MIS was evaluated using linear regression analysis. Third, to further verify this association at the molecular level, we explored the potential shared genes associated with related fat obtained in the above steps and acute myocardial infarction via bioinformatics analysis using the Gene Expression Omnibus (GEO) database. Finally, the association between the expression of shared genes in the serum of patients with STEMI and related fat was confirmed using Pearson’s correlation analysis. Results: The volume and fat attenuation index of IF and PF showed no difference between patients with MIS and those without. However, the L/S of NAFLD on CT reduced significantly in patients with MIS (P =0.001). The L/S of NAFLD on CT was an independent predictor of MIS on SPECT-MPI in patients with STEMI (P =0.042). We identified ST2, THBD, LEPR, and CEBP-α in NAFLD and acute myocardial infarction cases from the GEO database (P <0.05). Compared to patients with STEMI without NAFLD, those with NAFLD exhibited a reduction in sST2 levels (P=0.042); however, no differences were observed in THBD, LEPR, and CEBP-α levels. Correlation analysis showed a positive correlation between L/S and sST2 levels (r=0.459, P =0.032). Conclusions:Among patients with STEMI, the L/S of NAFLD, but not IF or PF, was associated with MIS on SPECT-MPI. Additionally, the L/S of NAFLD on CT emerged as an independent predictor of MIS. The expression of sST2, a biomarker associated with NAFLD and STEMI, positively correlated with the L/S on CT imaging.