Key result
In patients with metabolic syndrome, MAFLD was associated with significantly lower magnitude left ventricular global longitudinal strain (-11.6% vs -13.8%) and impaired atrioventricular coupling.
Why the study?
MAFLD was recently recognized as an important risk factor for cardiovascular diseases, prompting evaluation of its effect on cardiac function in metabolic syndrome by MRI.
Does the presence of MAFLD worsen left ventricular deformation and atrioventricular coupling in patients with metabolic syndrome?
Observational (n=260)
Does the presence of MAFLD worsen left ventricular deformation and atrioventricular coupling in patients with metabolic syndrome?
Effect estimate: β = -0.270
Absolute Event Rate: -11.6% vs -13.8%
p-value: p=<0.05
In patients with metabolic syndrome, the presence of MAFLD is independently associated with worse subclinical left ventricular dysfunction and impaired atrioventricular coupling as assessed by MRI.
BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD) was recently recognized as an important risk factor for cardiovascular diseases. PURPOSE: To examine the effect of MAFLD on cardiac function in metabolic syndrome by MRI. STUDY TYPE: Retrospective. POPULATION: One 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/SEQUENCE: 3.0 T; balanced steady-state free precession sequence. ASSESSMENT: Left 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 TESTS: Student's t test or Mann-Whitney U test; One-way analysis of variance. A P value <0.05 was considered statistically significant. RESULTS: Among 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 CONCLUSION: MAFLD 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 LEVEL: 3 TECHNICAL EFFICACY: 3.
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Huang et al. (2023) conducted an observational in Metabolic syndrome (n=260). Metabolic dysfunction-associated fatty liver disease (MAFLD) vs. Metabolic syndrome without MAFLD was evaluated on Left ventricular global longitudinal strain (LV-GLS) (β = -0.270, p=<0.05). In patients with metabolic syndrome, MAFLD was associated with significantly lower magnitude left ventricular global longitudinal strain (-11.6% vs -13.8%) and impaired atrioventricular coupling.
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