Nonalcoholic fatty liver disease is independently associated with early left ventricular diastolic dysfunction in patients with type 2 diabetes

Mantovani, Alessandro; Pernigo, Matteo; Bergamini, Corinna; Bonapace, Stefano; Pichiri, Isabella; Bertolini, Lorenzo; Valbusa, Filippo; Barbieri, Enrico; Zoppini, Giacomo; Bonora, Enzo; Targher, Giovanni

doi:10.1016/j.dld.2015.07.031

Cited by 9 publications

(11 citation statements)

References 37 publications

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“…There are also divergent reports on this matter in diabetic populations [45][46][47]. To our knowledge, there is only one previous study in which the association of NAFLD and LVMI was studied after adjusting with metabolic syndrome [48].…”

Section: Accepted Manuscriptmentioning

confidence: 76%

Non-alcoholic fatty liver disease with and without metabolic syndrome: Different long-term outcomes

et al. 2017

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Section: Accepted Manuscriptmentioning

confidence: 76%

Non-alcoholic fatty liver disease with and without metabolic syndrome: Different long-term outcomes

et al. 2017

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“…Although more research is needed to identify mechanistic clues, some putative pathophysiological mechanisms may be proposed to explain the strong association between NAFLD and ventricular arrhythmias. Growing evidence suggests that NAFLD is not only associated with an increased risk of cardiovascular events and death, but is also associated with subclinical myocardial remodeling, an increase in LV filling pressures, and enlarged left atrial volume (5,7,(20)(21)(22)(23). Previous studies (24)(25)(26)(27)(28) have also shown that patients with NAFLD have an increased risk of atrial fibrillation compared with those without NAFLD.…”

Section: Discussionmentioning

confidence: 95%

Nonalcoholic Fatty Liver Disease Is Associated With Ventricular Arrhythmias in Patients With Type 2 Diabetes Referred for Clinically Indicated 24-Hour Holter Monitoring

et al. 2016

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OBJECTIVERecent studies have suggested that nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of heart rate-corrected QT interval prolongation and atrial fibrillation in patients with type 2 diabetes. Currently, no data exist regarding the relationship between NAFLD and ventricular arrhythmias in this patient population. RESEARCH DESIGN AND METHODSWe retrospectively analyzed the data of 330 outpatients with type 2 diabetes without preexisting atrial fibrillation, end-stage renal disease, or known liver diseases who had undergone 24-h Holter monitoring for clinical reasons between 2013 and 2015. Ventricular arrhythmias were defined as the presence of nonsustained ventricular tachycardia (VT), >30 premature ventricular complexes (PVCs) per hour, or both. NAFLD was diagnosed by ultrasonography. RESULTSCompared with patients without NAFLD, those with NAFLD (n = 238, 72%) had a significantly higher prevalence of >30 PVCs/h (19.3% vs. 6.5%, P < 0.005), nonsustained VT (14.7% vs. 4.3%, P < 0.005), or both (27.3% vs. 9.8%, P < 0.001). NAFLD was associated with a 3.5-fold increased risk of ventricular arrhythmias (unadjusted odds ratio [OR] 3.47 [95% CI 1.65-7.30], P < 0.001). This association remained significant even after adjusting for age, sex, BMI, smoking, hypertension, ischemic heart disease, valvular heart disease, chronic kidney disease, chronic obstructive pulmonary disease, serum g-glutamyltransferase levels, medication use, and left ventricular ejection fraction (adjusted OR 3.01 [95% CI 1.26-7.17], P = 0.013). CONCLUSIONSThis is the first observational study to show that NAFLD is independently associated with an increased risk of prevalent ventricular arrhythmias in patients with type 2 diabetes.

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“…Although multiple studies have observed associations with NAFLD and left ventricular (LV) dysfunction, 12,24‐40 right ventricular (RV) dysfunction 41,42 and LV hypertrophy, 43 some results are conflicting, 44,45 most include small sample sizes or narrow populations, or did not adequately account for potential confounding variables. Additionally, prior studies have not explored the possible mediation effect of general adiposity, as measured by body mass index (BMI), on the association between NAFLD and subclinical CVD.…”

Section: Introductionmentioning

confidence: 99%

The association of non‐alcoholic fatty liver disease and cardiac structure and function—Framingham Heart Study

Chiu

Pedley

Massaro

et al. 2020

Liver International

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Background & Aims: Non-alcoholic fatty liver disease confers increased risk for cardiovascular disease, including heart failure (HF), for reasons that remain unclear. Possible pathways could involve an association of liver fat with cardiac structural or functional abnormalities even after accounting for body size. Methods: We analysed N = 2356 Framingham Heart Study participants (age 52 ± 12 years, 52% women) who underwent echocardiography and standardized computed tomography measures of liver fat. Results: In cross-sectional multivariable regression models adjusted for age, gender, cohort and cardiovascular risk factors, liver fat was positively associated with left ventricular (LV) mass (β = 1.45; 95% confidence interval (CI): 0.01, 2.88), LV wall thickness (β = 0.01; 95% CI: 0.00, 0.02), mass volume ratio (β = 0.02; 95% CI 0.01, 0.03), mitral peak velocity (E) (β = 0.83; 95% CI 0.31, 1.36) and LV filling pressure (E/e′ ratio) (β = 0.16; 95% CI 0.09, 0.23); and inversely associated with global systolic longitudinal strain (β = 0.20, 95% CI 0.07, 0.33), diastolic annular velocity (e′) (β = −0.12; 95%

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Nonalcoholic fatty liver disease is independently associated with early left ventricular diastolic dysfunction in patients with type 2 diabetes

Cited by 9 publications

References 37 publications

Non-alcoholic fatty liver disease with and without metabolic syndrome: Different long-term outcomes

Non-alcoholic fatty liver disease with and without metabolic syndrome: Different long-term outcomes

Nonalcoholic Fatty Liver Disease Is Associated With Ventricular Arrhythmias in Patients With Type 2 Diabetes Referred for Clinically Indicated 24-Hour Holter Monitoring

The association of non‐alcoholic fatty liver disease and cardiac structure and function—Framingham Heart Study

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