Effect of Metabolic Dysfunction‐Associated Fatty Liver Disease on Left Ventricular Deformation and Atrioventricular Coupling in Patients With Metabolic Syndrome Assessed by MRI

Abstract

BackgroundMetabolic dysfunction‐associated fatty liver disease (MAFLD) was recently recognized as an important risk factor for cardiovascular diseases.PurposeTo examine the effect of MAFLD on cardiac function in metabolic syndrome by MRI.Study TypeRetrospective.PopulationOne hundred seventy‐nine patients with metabolic syndrome (MetS), 101 with MAFLD (MAFLD [+]) and 78 without (MAFLD [−]). Eighty‐one adults without any of the components of MetS or cardiac abnormalities were included as control group.Field Strength/Sequence3.0 T; balanced steady‐state free precession sequence.AssessmentLeft atrial (LA) strain was assessed during three phases: reservoir strain (LA‐RS), conduit strain (LA‐CS), and booster strain (LA‐BS). Left ventricular (LV) global longitudinal (LV‐GLS) strain was also derived. The left atrioventricular coupling index (LACI) was calculated as the ratio of LA end‐diastolic volume (LA‐EDV) and LV‐EDV.Statistical TestsStudent's t test or Mann–Whitney U test; One‐way analysis of variance. A P value <0.05 was considered statistically significant.ResultsAmong MetS patients, individuals with MAFLD had significantly lower magnitude LV‐GLS (−11.6% ± 3.3% vs. −13.8% ± 2.7%) than those without MAFLD. For LA strains, LA‐RS (36.9% ± 13.7% vs. 42.9% ± 13.5%) and LA‐CS (20.0% ± 10.6% vs. 24.1% ± 9.2%) were also significantly reduced in MAFLD (+) compared to MAFLD (−). The LACIs (17.2% [12.9–21.2] % vs. 15.8% [12.2–19.7] %) were significantly higher in patients with MAFLD compared to those without MAFLD. After adjustment for other clinical factors, MAFLD was found to be independently correlated with LV‐GLS (β = −0.270) and LACI (β = 0.260).Data ConclusionMAFLD had an unfavorable effect on LV myocardial strain in MetS. Moreover, LA strain and atrioventricular coupling were further impaired in patients with concomitant MAFLD compared to those without MAFLD. Last, MAFLD was independently associated with subclinical LV dysfunction and atrioventricular coupling after adjustment for other clinical factors.Evidence Level3Technical Efficacy3

Editorial for “Effect of Metabolic Dysfunction‐Associated Fatty Liver Disease on Left Ventricular Deformation and Atrioventricular Coupling in Patients With Metabolic Syndrome Assessed byMRI”

“…In this issue of JMRI, Huang et al attempted to address this knowledge gap by evaluating strain using feature-tracking MRI in 179 patients with metabolic syndrome and 81 healthy adults. 10 The authors employed a single-center retrospective cohort design in subjects with metabolic syndrome who underwent a cardiac MRI at their institution between January 2017 and June 2022. In addition to performing left ventricular and left atrial strain on the preexisting cine Steady-state free precession (SSFP) images, they also collected clinical risk factor data on the subjects who underwent the MRI and the healthy controls.…”

“…In this issue of JMRI, Huang et al attempted to address this knowledge gap by evaluating strain using feature‐tracking MRI in 179 patients with metabolic syndrome and 81 healthy adults 10 . The authors employed a single‐center retrospective cohort design in subjects with metabolic syndrome who underwent a cardiac MRI at their institution between January 2017 and June 2022.…”