Key result
In a general population without overt cardiac or liver disease, NAFLD was associated with a significantly higher frequency of abnormal left ventricular global longitudinal strain (31.0% vs 10.7%; P<0.001).
Why the study?
Emerging evidence suggests an association between NAFLD and HF, prompting investigation into the relationship between NAFLD and LV functional remodelling in a general population sample without overt cardiac and liver disease.
Is non-alcoholic fatty liver disease associated with subclinical left ventricular dysfunction in the general population?
Cross-Sectional (n=481)
Is non-alcoholic fatty liver disease associated with subclinical left ventricular dysfunction in the general population?
Absolute Event Rate: 31% vs 10.7%
p-value: p=<0.001
In a general population without overt heart or liver disease, NAFLD is independently associated with subclinical left ventricular dysfunction, potentially explaining the increased risk of heart failure in these patients.
NAFLD linked to impaired LVGLS in general population; supports liver-heart axis but hypothesis-generating and should not yet change practice.
Aims Emerging evidence suggests an association between non-alcoholic fatty liver disease (NAFLD) and heart failure (HF). We investigated the relationship between NAFLD and left ventricular (LV) functional remodelling in a general population sample without overt cardiac and liver disease. Methods and results We included 481 individuals without significant alcohol consumption who voluntarily underwent an extensive cardiovascular health check. The fatty liver index (FLI) was calculated for each participant, and NAFLD was defined as FLI ≥ 60. All participants underwent 2D transthoracic echocardiography; LV global longitudinal strain (LVGLS) was assessed with speckle-tracking analysis. Univariable and multivariable linear regression models were constructed to investigate the possible association between NAFLD and LVGLS. Seventy-one (14.8%) participants were diagnosed with NAFLD. Individuals with NAFLD exhibited larger LV size and LV mass index than those without NAFLD, although left atrial size and E/e′ ratio did not differ between groups. Left ventricular global longitudinal strain was significantly reduced in participants with vs. without NAFLD (17.1% ± 2.4% vs. 19.5% ± 3.1%, respectively; P < 0.001). The NAFLD group had a significantly higher frequency of abnormal LVGLS (<16%) than the non-NAFLD group (31.0% vs. 10.7%, respectively; P < 0.001). Multivariable linear regression analysis demonstrated that higher FLI score was significantly associated with impaired LVGLS independent of age, sex, conventional cardiovascular risk factors, and echocardiographic parameters (standardized β −0.11, P = 0.031). Conclusion In the general population without overt cardiac and liver disease, the presence of NAFLD was significantly associated with subclinical LV dysfunction, which may partly explain the elevated risk of HF in individuals with NAFLD.
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Hirose et al. (2023) conducted a cross-sectional in General population without overt cardiac and liver disease (n=481). Non-alcoholic fatty liver disease (NAFLD) vs. No NAFLD was evaluated on Abnormal left ventricular global longitudinal strain (<16%) (p=<0.001). In a general population without overt cardiac or liver disease, NAFLD was associated with a significantly higher frequency of abnormal left ventricular global longitudinal strain (31.0% vs 10.7%; P<0.001).
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