Impaired left ventricular mechanics in nonalcoholic fatty liver disease

Karabay, Can Yücel; Kocabay, Gönenç; Kalaycı, Arzu; Çolak, Yaşar; Oduncu, Vecih; Akgün, Taylan; Kalkan, Sedat; Güler, Ahmet; Kırma, Cevat

doi:10.1097/meg.0000000000000008

Cited by 40 publications

(30 citation statements)

References 18 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have indicated the close relationship between impaired LV longitudinal function and dysmetabolic state, such as diabetes mellitus [24], normal-weight obesity (visceral obesity) [25], and nonalcoholic steatohepatitis [26]. Our study provides novel information suggesting the role of IR on an early impairment of the longitudinal function, independently of concomitant visceral obesity and LV hypertrophy.…”

Section: Discussionmentioning

confidence: 51%

Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis

Utsunomiya

Yamamoto

Kunita

et al. 2014

Cardiovasc Diabetol

View full text Add to dashboard Cite

BackgroundInsulin resistance, as a key mediator of metabolic syndrome, is thought to be associated with pathogenesis of calcific aortic valve disease and altered left ventricular (LV) function and structure. However, in patients with aortic valve sclerosis (AVS), the association between insulin resistance and subclinical impairment of LV function is not fully elucidated.MethodsWe studied 57 patients (mean age 70 ± 8 years, 22 women) with asymptomatic AVS but normal LV ejection fraction in echocardiography. LV longitudinal and circumferential strain and strain rate was analyzed using two-dimensional speckle tracking echocardiography. Patients with uncontrolled hypertension and diabetes mellitus, chronic kidney disease, and concomitant coronary artery disease were excluded. They were divided into the insulin-resistant group (AVS+IR; N = 28) and no insulin-resistant group (AVS-IR; N = 29) according to the median value of homeostatic model assessment index. Computed tomography scans were also performed to measure the aortic valve calcium score and the visceral adipose tissue (VAT) area. In addition, age- and sex- adjusted 28 control subjects were recruited for the comparison.ResultsThere were no significant differences in LV ejection fraction or mass index among the groups. The AVS+IR group had a higher aortic valve calcium score (median 94 versus 21, P = 0.022) and a larger VAT area (113 ± 42 cm2 versus 77 ± 38 cm2, P = 0.001) than the AVS-IR group. Notably, LV global longitudinal strain, strain rate (SR), and early diastolic SR were significantly lower in the AVS+IR group than in the AVS-IR group and in control subjects (strain: -16.2 ± 1.6% versus -17.2 ± 1.2% and -18.9 ± 0.8%; SR: -1.18 ± 0.26 s-1 versus -1.32 ± 0.21 s-1 and -1.52 ± 0.08 s-1; early diastolic SR: -1.09 ± 0.23 s-1 versus -1.23 ± 0.18 s-1 and -1.35 ± 0.12 s-1; P < 0.05 for all comparison), whereas circumferential function were not significantly different. Multiple linear regression analyses revealed insulin resistance as an independent determinant of LV longitudinal strain (P = 0.017), SR (P = 0.047), and early diastolic SR (P = 0.049) regardless of LV mass index or VAT area.ConclusionsInsulin resistance is a powerful independent predictor of subclinical LV dysfunction regardless of concomitant visceral obesity and LV hypertrophy. Thus, it may be a novel therapeutic target to prevent subsequent heart failure in patients with AVS.

show abstract

Section: Discussionmentioning

confidence: 51%

Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis

Utsunomiya

Yamamoto

Kunita

et al. 2014

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…LA-Res and LA-pump significantly lower in NAFLD subgroups. There were significant differences in LA-SR(A) between healthy controls compared with simple steatosis and borderline Karabay et al [47] 55 NAFLD patients and 21 healthy controls. Biopsy-proven NAFLD.…”

Section: Ref Methods Resultsmentioning

confidence: 99%

“…Those patients with biopsy-proven NASH had a significantly lower e' velocity and higher E-to-e' and Tei index than those with only NAFLD [45] . The use of 2D speckle tracking echocardiography to determine left atrial deformation parameters was not found to be helpful in a recent study on 55 NAFLD patients and 21 controls from Turkey [46,47] . These studies are summarized in Table 2.…”

Section: Ref Methods Resultsmentioning

confidence: 99%

Non-alcoholic fatty liver disease - the heart of the matter

Azzam

Malnick

2015

WJH

View full text Add to dashboard Cite

Non-alcoholic fatty liver disease (NAFLD) is one of the most common forms of chronic liver disease in the Western world. There is a close association with the metabolic syndrome and NAFLD is considered to be the hepatic manifestation of the metabolic syndrome. The components of the metabolic syndrome include hypertension, obesity and insulin resistance which are well established cardiovascular risk factors. The mortality rate of NAFLD patients from myocardial infarction is higher than that in the general United States population and there is also an increased risk of nonfatal cardiovascular events. This article reviews the cardiovascular complications associated with NAFLD. In order to provide comprehensive care of NAFLD patients, physicians need to be aware of, and search for, the cardiac morbidity associated with NAFLD. Core tip: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Due to the overlapping cardiovascular risk factors in the metabolic syndrome, there are cardiovascular consequences linked to the presence of NAFLD in a patient. We review these complications and also a less well appreciated complication of diastolic dysfunction that is intimately associated with NAFLD. Physicians looking after NAFLD patients need to be aware of these complications and actively search for and treat them.Azzam H, Malnick S. Non-alcoholic fatty liver disease -the heart of the matter. World J Hepatol 2015; 7(10):

show abstract

“…78 NASH has been associated with several markers of subclinical myocardial dysfunction with a propensity towards development of symptomatic diastolic dysfunction in both children and adults. [79][80][81] NASH is independently associated with increased left atrial volume, a powerful predictor of morbidity and mortality in HF. 82 Echocardiography is the primary screening modality among LT candidates for the presence of HF and risk markers for the development of HF.…”

Section: Heart Failure and Cardiomyopathymentioning

confidence: 99%

Multidisciplinary approach to cardiac and pulmonary vascular disease risk assessment in liver transplantation: An evaluation of the evidence and consensus recommendations

VanWagner

Harinstein

Runo

et al. 2018

American Journal of Transplantation

113

181

View full text Add to dashboard Cite

Liver transplant (LT) candidates today are older, have greater medical severity of illness, and have more cardiovascular comorbidities than ever before. In addition, there are specific cardiovascular responses in cirrhosis that can be detrimental to the LT candidate. Cirrhotic cardiomyopathy, a condition characterized by increased cardiac output and a reduced ventricular response to stress, is present in up to 30% of patients with cirrhosis, thus challenging perioperative management. Current noninvasive tests that assess for subclinical coronary and myocardial disease have low sensitivity, and altered hemodynamics during the LT surgery can unmask latent cardiovascular disease either intraoperatively or in the immediate postoperative period. Therefore, this review, assembled by a group of multidisciplinary experts in the field and endorsed by the American Society of Transplantation Liver and Intestine and Thoracic and Critical Care Communities of Practice, provides a critical assessment of the diagnosis of cardiac and pulmonary vascular disease and interventions aimed at managing these conditions in LT candidates. Key points and practice-based recommendations for the diagnosis and management of cardiac and pulmonary vascular disease in this population are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.

show abstract

Impaired left ventricular mechanics in nonalcoholic fatty liver disease

Abstract: Patients with NAFLD and its subgroups have evidence of subclinical myocardial dysfunction in relation to the presence of insulin resistance. 2D-STE could not be used for differentiation of the NAFLD subgroups.

Cited by 40 publications

References 18 publications

Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis

Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis

Non-alcoholic fatty liver disease - the heart of the matter

Multidisciplinary approach to cardiac and pulmonary vascular disease risk assessment in liver transplantation: An evaluation of the evidence and consensus recommendations

Contact Info

Product

Resources

About