Profiles of patients with cardiovascular risk factors and the severity of hepatic steatosis and fibrosis assessed by pulsed ultrasound

Fatty liver disease, although present on the list of factors increasing cardiovascular risk in people with cardiological burden, is not often diagnosed in out-patients of cardiology clinics due to the low availability of equipment for non-invasive tests. An additional factor increasing mortality, especially in patients with heart failure, is liver fibrosis, which can also be assessed non-invasively. The aim of our study was to assess the advancement of fatty changes and fibrosis in the liver in out-patients of the cardiology clinic with hypertension, hyperlipidemia, type 2 diabetes, obesity and/or coronary artery disease and the relationship of these changes with the patient's biochemical profile and the result of echocardiographic assessment. Method: 93 patients using cardiology consultations ordered by a family doctor underwent an echocardiographic examination, a liver examination using pulsed ultrasound and blood tests: lipid profile, fasting glucose level, HbA1c, creatinine level with eGRF assessment. In the echocardiographic examination, the left ventricular ejection fraction EFLV, left atrial diameter LA, right ventricular diameter RV, interventricular septum thickness IVS, tricuspid valve annulus velocity TAPSE and pulmonary valve flow acceleration time AcT were assessed. Pulsed-wave ultrasonography was used to assess the controlled attenuation parameter of the liver parenchyma CAP expressed in dB and the stiffness E, a measure of fibrosis expressed in kPa. Patients were divided into tertiles according to the CAP and E scores. Intertertile differences in anthropomorphic, biochemical and echocardiographic parameters were compared and correlations between the severity of liver steatosis and fibrosis with the assessed parameters were assessed. The results (only with statistical significance) for the assessment of liver steatosis are presented in Table 1, and for liver fibrosis in Table 2. Conclusions: The occurrence of liver steatosis is underestimated in patients with risk factors for coronary artery disease, and the concentration of glucose, HbA1c, triglycerides and LDL cholesterol differs significantly depending on the advancement of steatosis, significant differences were also noted for selected 5 echocardiographic parameters. Liver fibrosis is a rare phenomenon among patients with cardiological burden without heart failure, the detection of which requires at least pulsed ultrasound examination. Intertercile differences depending on the result of tissue stiffness measurement were found for the same biochemical parameters as for steatosis and in group of echocardiographic parameters for pulmonary valve flow velocity, which was, however, within the normal range.