Association of Metabolic Dysfunction-Associated Fatty Liver Disease With Left Ventricular Diastolic Function and Cardiac Morphology

Abstract

Background and AimNon-alcoholic fatty liver disease (NAFLD) is closely related to cardiovascular diseases (CVD). A newly proposed definition is metabolic dysfunction-associated fatty liver disease (MAFLD), which was changed from NAFLD. The clinical effect of this change on abnormalities of cardiac structure and function is yet unknown. We aimed to examine whether MAFLD is associated with left ventricular (LV) diastolic dysfunction (LVDD) and cardiac remolding and further identify the impact of different subgroups and severity of MAFLD.MethodWe evaluated 228 participants without known CVDs. Participants were categorized by the presence of MAFLD and the normal group. Then, patients with MAFLD were subclassified into three subgroups: MAFLD patients with diabetes (diabetes subgroup), overweight/obesity patients (overweight/obesity subgroup), and lean/normal-weight patients who had two metabolic risk abnormalities (lean metabolic dysfunction subgroup). Furthermore, the severity of hepatic steatosis was assessed by transient elastography (FibroScan®) with a controlled attenuation parameter (CAP), and patients with MAFLD were divided into normal, mild, moderate, and severe hepatic steatosis groups based on CAP value. Cardiac structure and function were examined by echocardiography.ResultsLVDD was significantly more prevalent in the MAFLD group (24.6% vs. 60.8%, p < 0.001) compared to the normal group. The overweight subgroup and diabetes subgroup were significantly associated with signs of cardiac remolding, including interventricular septum thickness, LV posterior wall thickness, left atrial diameter (all p < 0.05), relative wall thickness, and LV mass index (all p < 0.05). Additionally, moderate-to-to severe steatosis patients had higher risks for LVDD and cardiac remolding (all p-values < 0.05).ConclusionMAFLD was associated with LVDD and cardiac remolding, especially in patients with diabetes, overweight patients, and moderate-to-to severe steatosis patients. This study provides theoretical support for the precise prevention of cardiovascular dysfunction in patients with MAFLD.

Non-Alcoholic Fatty Liver Disease and Echocardiographic Parameters of Left Ventricular Diastolic Function: A Systematic Review and Meta-Analysis

“…From the initial search, 2619 studies were identified. Ultimately, 38 of them were included in the systematic review [ 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. Furthermore, 31 of them were found eligible for meta-analysis ( Figure 1 ), since 7 of the studies included in the systematic review did not have the required quantitative data.…”

Ultrasound-Based Diagnostic Methods: Possible Use in Fatty Liver Disease Area

“…LS-associated metabolic syndrome was associated with left ventricular diastolic dysfunction and cardiac remodeling. These studies provide theoretical support for precise cardiovascular dysfunction prevention in patients with LS [ 45 , 46 ]. A slightly contradictory conclusion was reached by an observational study by Cardoso et al, who followed DM2 patients for 5.5 years and identified a protective effect of a higher CAP value on mortality, even in the cardiovascular mortality subgroup.…”

An international multidisciplinary consensus statement on MAFLD and the risk of CVD

“…This meta-analysis also found that concomitant metabolic risk factors and liver disease severity were independently associated with abnormalities in cardiac function. Finally, Peng et al [ 66 ]. found that MAFLD was associated with left ventricular diastolic dysfunction and cardiac remodeling (including greater inter-ventricular septum thickness and left ventricular posterior wall thickness, as well as larger left atrial diameter and greater left ventricular hypertrophy), especially in patients with coexisting T2DM or obesity and in those with moderate-to-severe hepatic steatosis.…”