Non-Alcoholic Fatty Liver Disease Association with Cardiac Arrhythmias

Abstract

Non-alcoholic fatty liver disease (NAFLD) has become a public health burden all over the world. A significant percentage of the patients with NAFLD have a co-existing metabolic syndrome that is a risk factor for cardiovascular disease. Clinical as well as epidemiological research shows that NAFLD is not simply related to liver-related morbidity and mortality but is also associated with an elevated risk of coronary heart disease (CHD), irregularities of cardiac function as well as cardiac structure, valvular heart disease, and arrhythmias. Animal studies suggest that NAFLD by itself exacerbates systemic/hepatic insulin resistance, leads to atherogenic dyslipidemia and generates a number of pro-inflammatory, pro-coagulant and profibrogenic mediators which play an essential role in the pathophysiology of cardiac abnormalities including arrhythmias. Hence, it is suggested that the patients with NAFLD may derive benefit from intensive monitoring and treatment methods to reduce the risk of CHD along with other cardiac/arrhythmic complications. The intent of this clinical review is to sum up the quickly increasing body of evidence that provides support for a robust relationship between NAFLD and cardiac arrhythmias and to present the putative biological mechanisms underlying this correlation.

Cardiovascular comorbidity in non-alcoholic fatty liver disease

“…The importance of further study of this issue is due to the mutual infl uence of non-alcoholic fatty liver disease and cardiovascular disease not only on the prognosis, but also on the tactics of patient management. 14,15,16]. В проведенном G. Musso с соавт.…”

“…НАЖБП усугубляет ИР, что приводит к выработке большего количества провоспалительных, прокоагулянтных и профиброгенных медиаторов и способствует развитию структурных нарушений в миокарде и эндотелии. Однако, роль биомаркеров воспаления при НАЖБП и ССЗ изучена недостаточно [14,15,37]. Одно из крупнейших исследований по этому вопросу (Multi-Ethnic Study of Atherosclerosis) [38] показало, что повышение циркулирующего интерлейкина-6 (ИЛ-6) при НАЖБП ассоциировано с заболеваниями сердца и сосудов, особенно с образованием бляшек в коронарных артериях.…”

TRIB1 rs17321515 gene polymorphism increases the risk of coronary heart disease in general population and non-alcoholic fatty liver disease patients in Chinese Han population

“…Clinical experience and epidemiological evidences showed that NAFLD-related mortality not only referred to the liver itself, but also companied with the complication such as the increased risk of CHD [33, 34]. NAFLD could aggravate insulin resistance in the body and liver that cause atherosclerotic dyslipidemia, and release a variety of pro-inflammatory, pro-coagulant, and pro-fibrotic mediators, which may play an important role in the pathophysiology of cardiac and arrhythmia complications [33, 35]. Single nucleotide polymorphism (SNP) as a significant genetic factor, plays an important role in the development of NAFLD and CHD [36, 37].…”

Early cardiac electrical and structural changes in patients with non-obese non-alcoholic fatty liver disease

“…Arrhythmias are one of the main cardiovascular diseases in which NAFLD causes an increased risk. Clinical studies have found that NAFLD is associated with increased frequency of supraventricular and ventricular arrhythmias [30,31]. AF is the most common arrhythmia in these patients with increased risk of NAFLD [32,33].…”