Association of nonalcoholic fatty liver disease with QTc interval in patients with type 2 diabetes

Targher, Giovanni; Valbusa, Filippo; Bonapace, Stefano; Bertolini, Lorenzo; Zenari, Luciano; Pichiri, Isabella; Mantovani, Alessandro; Zoppini, Giacomo; Bonora, Enzo; Barbieri, Enrico; Byrne, Christopher D.

doi:10.1016/j.numecd.2014.01.005

Cited by 87 publications

(85 citation statements)

References 30 publications

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“…This finding corroborates previous observations reporting a strong association between NAFLD and an increased risk of QTc interval prolongation, which is a powerful risk factor for ventricular arrhythmias (8,9). In particular, we recently demonstrated that NAFLD was associated with an increased QTc interval among patients with type 2 diabetes without known liver diseases, and this association remained significant after adjusting for age, sex, hypertension, diabetes-related variables, LV hypertrophy, and comorbid conditions (8). Similarly, Hung et al (9) reported that the ultrasonographic severity of NAFLD was associated with a higher risk for QTc interval prolongation in a large populationbased study, independently of age, sex, hypertension, diabetes, total cholesterol, eGFR, BMI, LV hypertrophy, history of IHD, or hypokalemia.…”

Section: Discussionsupporting

confidence: 92%

“…However, it is important to emphasize that the association between NAFLD and ventricular arrhythmias remained significant in our study even after adjusting for many cardiometabolic risk factors, LV ejection fraction, preexisting IHD, and comorbid conditions. This finding corroborates previous observations reporting a strong association between NAFLD and an increased risk of QTc interval prolongation, which is a powerful risk factor for ventricular arrhythmias (8,9). In particular, we recently demonstrated that NAFLD was associated with an increased QTc interval among patients with type 2 diabetes without known liver diseases, and this association remained significant after adjusting for age, sex, hypertension, diabetes-related variables, LV hypertrophy, and comorbid conditions (8).…”

Section: Discussionsupporting

confidence: 92%

“…Preliminary evidence has suggested that NAFLD is associated with an increased prevalence of heart rate-corrected QT interval prolongation (i.e., an established risk factor for ventricular arrhythmias), independent of many cardiometabolic risk factors, both in patients with and without diabetes (8,9).…”

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confidence: 99%

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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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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

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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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“…Recent data also suggested that the presence and severity NAFLD on ultrasonography was independently associated with increased QTc interval duration (i.e., a powerful predictor of ventricular arrhythmias and sudden cardiac death), which might partly account for the increased CVD mortality associated with NAFLD [50].…”

Section: Nafld Cardiac Arrhythmias and Heart Valve Calcificationmentioning

confidence: 99%

Non-alcoholic fatty liver disease and risk of cardiovascular disease

et al. 2016

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“…Thus, NAFLD may play a pathogenic role in the development of clinical HF, particularly HF with preserved ejection fraction. Finally, NAFLD has been independently associated with an increased risk of dysrhythmia(57), including atrial fibrillation(58), prolonged QTc interval(59)(a strong predictor of sudden cardiac death) and cardiac autonomic dysfunction(60). …”

Section: Introductionmentioning

confidence: 99%

Extrahepatic Manifestations of Nonalcoholic Fatty Liver Disease

VanWagner

Rinella

2016

Curr Hepatology Rep

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide with an increased prevalence of metabolic, macro- and microvascular complications. The primary causes of mortality in NAFLD are cardiovascular disease (CVD), malignancy and liver disease. NAFLD is a multisystem disease that affects a variety of extra-hepatic organ systems. The main focus of this review is to summarize the reported extra-hepatic associations, which include CVD, chronic kidney disease, obstructive sleep apnea, osteoporosis, psoriasis, colorectal cancer, iron overload and various endocrinopathies (e.g. type 2 diabetes mellitus, thyroid dysfunction, and polycystic ovarian syndrome). Due to the systemic manifestations of NAFLD patients require a multidisciplinary assessment and may benefit from more rigorous surveillance and early treatment interventions to decrease mortality related to malignancy or cardiometabolic diseases.

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Association of nonalcoholic fatty liver disease with QTc interval in patients with type 2 diabetes

Cited by 87 publications

References 30 publications

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

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

Non-alcoholic fatty liver disease and risk of cardiovascular disease

Extrahepatic Manifestations of Nonalcoholic Fatty Liver Disease

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