Metabolic dysfunction-associated steatotic liver disease was associated with a medium reduction in left ventricular global longitudinal strain (SMD -0.6894; 95% CI -0.895, -0.472; p<0.001).
Meta-Analysis (n=7,446)
Does the presence of MASLD impair left ventricular mechanics in patients without overt cardiac disease?
MASLD is associated with subclinical left ventricular systolic dysfunction as detected by impaired global longitudinal strain, even in the absence of overt cardiac disease.
Effect estimate: SMD -0.6894 (95% CI -0.895, -0.472)
p-value: p=< 0.001
Background: Over the last two decades, a fair number of echocardiographic studies have investigated the influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on myocardial strain and strain rate parameters assessed by speckle tracking echocardiography (STE) in individuals without overt heart disease, reporting not univocal results. We aimed at analyzing the main findings of these studies. Methods: All studies examining conventional echoDoppler parameters by transthoracic echocardiography (TTE) and left ventricular (LV) mechanics LV-global longitudinal strain (GLS), LV-global strain rate in systole (GSRs), in early diastole (GSRe) and late diastole (GSRl) by STE in MASLD patients without known heart disease vs. healthy individuals, were searched on PubMed, Embase and Scopus databases. The primary endpoint was to quantify the effect of MASLD on LV-GLS in individuals without overt cardiac disease. Continuous data LV-GLS, LV-GLSRs, LV-GLSRe, LV-GLSRl and left ventricular ejection fraction (LVEF) were pooled as the standardized mean difference (SMD) comparing MASLD cohorts with healthy controls. Results: A total of 11 studies were included, totaling 1348 MASLD patients and 6098 healthy controls. Overall, MASLD showed a medium effect on LV-GLS (SMD −0.6894; 95%CI −0.895, −0.472, p 0.05). Sensitivity analysis confirmed the robustness of study results. Conclusions: MASLD has a medium effect on LV-GLS, independently of demographics, anthropometrics and the cardiovascular disease burden. STE analysis may allow early detection of subclinical LV systolic dysfunction in MASLD patients, potentially identifying those who may develop heart failure later in life.
Sonaglioni et al. (Tue,) conducted a meta-analysis in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) (n=7,446). Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) vs. Healthy controls was evaluated on Effect of MASLD on left ventricular global longitudinal strain (LV-GLS) (SMD -0.6894, 95% CI -0.895, -0.472, p=< 0.001). Metabolic dysfunction-associated steatotic liver disease was associated with a medium reduction in left ventricular global longitudinal strain (SMD -0.6894; 95% CI -0.895, -0.472; p<0.001).