Increased inter-atrial and intra-atrial conduction times in pediatric patients with non-alcoholic fatty liver disease

Doaa El Amrousy; Heba El Ashry; Sara Maher; Karim Elkashlan; Dina Abdelhai; Wegdan Mawlana; Samir Hasan

doi:10.1007/s00431-024-05809-8

October 22, 2024European Journal of PediatricsOpen Access

Increased inter-atrial and intra-atrial conduction times in pediatric patients with non-alcoholic fatty liver disease

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Why the study?

Pediatric NAFLD is linked to cardiovascular complications including AF, and this study aimed to explore the link between NAFLD and an increased risk of AF development.

Does non-alcoholic fatty liver disease (NAFLD) increase atrial electromechanical conduction delay in pediatric patients?

Structured PICO

Does non-alcoholic fatty liver disease (NAFLD) increase atrial electromechanical conduction delay in pediatric patients?

P

Population

200 children aged 14-18 years, comprising 100 newly diagnosed with non-alcoholic fatty liver disease (NAFLD) and 100 healthy controls.

I

Intervention

Non-alcoholic fatty liver disease (NAFLD) diagnosis

C

Comparator

Healthy individuals

O

Outcome

Atrial electromechanical conduction delay (EMD) values for inter-atrial, left intra-atrial, and right intra-atrial regions measured by transthoracic echocardiography and simultaneous ECGsurrogate

Pediatric patients with NAFLD demonstrate prolonged atrial electromechanical conduction times, suggesting an early substrate that may predispose them to atrial fibrillation in adulthood.

Implication

Pediatric NAFLD may associate with atrial EMD; hypothesis-generating for AF risk, needs prospective studies.

Abstract

The global incidence of pediatric non-alcoholic fatty liver disease (NAFLD) is rising, and it is linked to various potentially dangerous complications such as cardiovascular complications, particularly atrial fibrillation (AF). Atrial electromechanical conduction delay (EMD) has been reported as an early predictor for AF development. This study aimed to explore the link between NAFLD and the increased risk of AF development. This cross-sectional study was performed on 100 newly diagnosed NAFLD children (aged 14–18 years) as the patient group and 100 healthy individuals as a control group. Transthoracic echocardiography and simultaneous electrocardiography (ECG) recording were employed to estimate atrial electromechanical properties. EMD values were calculated for the inter-atrial, left intra-atrial, and right intra-atrial. Our results showed that pediatric patients with NAFLD exhibited significantly prolonged EMD values in the left and right intra-atrial as well as in inter-atrial regions compared to the control group ( P = 0.03, P < 0.001, P < 0.01, respectively). Conclusion : Children with NAFLD show atrial electromechanical alterations that may presage AF in adulthood. What is known: • The global incidence of pediatric non-alcoholic fatty liver disease (NAFLD) is rising, and it is linked to various potentially dangerous complications such as cardiovascular complications, particularly atrial fibrillation (AF). • Atrial electromechanical conduction delay (EMD) has been reported as an early predictor for AF development. What is new: • Children with NAFLD show atrial electromechanical alterations that may presage the appearance of AF in adulthood. • These children require multidisciplinary medical care to control liver disease and cardiovascular complications.