Salvatore Petta1, Christiano Argano2, Daniela Colomba2, Calogero Cammà3, Vito Di Marco3, Daniela Cabibi4, Antonino Tuttolomondo2, Giulio Marchesini5, Antonio Pinto2, Giuseppe Licata2, Antonio Craxì3. 1. Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Italy. Electronic address: salvatore.petta@unipa.it. 2. Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), Università di Palermo, Palermo, Italy. 3. Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Italy. 4. Cattedra di Anatomia Patologica, University of Palermo, Italy. 5. Dipartimento di Scienze Mediche e Chirurgiche, "Alma Mater Studiorum", Università di Bologna, Italy.
Abstract
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) has been associated with increased cardiovascular risk, including coronary artery disease and cardiac dysfunction. In addition, recent evidence highlighted the possible role of epicardial fat as a new cardiometabolic risk factor. We tested the correlation between epicardial fat, alterations in cardiac geometry and function, and severity of liver damage, in patients with biopsy-proven NAFLD. METHODS: The anthropometric, biochemical and metabolic features were recorded in 147 consecutive biopsy-proven NAFLD cases (Kleiner score). Epicardial fat thickness was measured by echocardiography. RESULTS: Epicardial fat was higher in patients with severe vs. milder fibrosis (8.5 ± 3.0 vs. 7.2 ± 2.3 mm; p=0.006); this association was maintained at multivariate logistic regression analysis (OR 1.22, 95%C.I. 1.01-1.47; p=0.04) after correction for gender, age >50 years, visceral obesity, IFG/diabetes, non-alcoholic steatohepatitis and severe steatosis. Of note, 37.1% of patients with epicardial fat >7 mm (median value) had severe liver fibrosis, compared to 18.3% of the cases with lower epicardial fat (p=0.01). As for echocardiographic indices, after adjusting for cardiometabolic confounders, diastolic posterior-wall thickness (p=0.01), left ventricular mass (p=0.03), relative wall thickness (p=0.02), and left atrial volume (0.04), as well as ejection fraction (p=0.004), lower lateral TDI e' (p=0.009), E/A ratio (0.04) (cardiac geometry alterations and diastolic dysfunction) were linked to severe liver fibrosis. CONCLUSIONS: In patients with NAFLD, a higher epicardial fat thickness is associated with the severity of liver fibrosis, in keeping with a possible pathogenic role of ectopic fat depots in whole body organ damage. In addition, morphological and functional cardiac alterations are more pronounced according to the severity of fibrosis. Further studies are needed to validate our results.
BACKGROUND & AIMS:Non-alcoholic fatty liver disease (NAFLD) has been associated with increased cardiovascular risk, including coronary artery disease and cardiac dysfunction. In addition, recent evidence highlighted the possible role of epicardial fat as a new cardiometabolic risk factor. We tested the correlation between epicardial fat, alterations in cardiac geometry and function, and severity of liver damage, in patients with biopsy-proven NAFLD. METHODS: The anthropometric, biochemical and metabolic features were recorded in 147 consecutive biopsy-proven NAFLD cases (Kleiner score). Epicardial fat thickness was measured by echocardiography. RESULTS: Epicardial fat was higher in patients with severe vs. milder fibrosis (8.5 ± 3.0 vs. 7.2 ± 2.3 mm; p=0.006); this association was maintained at multivariate logistic regression analysis (OR 1.22, 95%C.I. 1.01-1.47; p=0.04) after correction for gender, age >50 years, visceral obesity, IFG/diabetes, non-alcoholic steatohepatitis and severe steatosis. Of note, 37.1% of patients with epicardial fat >7 mm (median value) had severe liver fibrosis, compared to 18.3% of the cases with lower epicardial fat (p=0.01). As for echocardiographic indices, after adjusting for cardiometabolic confounders, diastolic posterior-wall thickness (p=0.01), left ventricular mass (p=0.03), relative wall thickness (p=0.02), and left atrial volume (0.04), as well as ejection fraction (p=0.004), lower lateral TDI e' (p=0.009), E/A ratio (0.04) (cardiac geometry alterations and diastolic dysfunction) were linked to severe liver fibrosis. CONCLUSIONS: In patients with NAFLD, a higher epicardial fat thickness is associated with the severity of liver fibrosis, in keeping with a possible pathogenic role of ectopic fat depots in whole body organ damage. In addition, morphological and functional cardiac alterations are more pronounced according to the severity of fibrosis. Further studies are needed to validate our results.
Authors: Justin McNair Canada; Antonio Abbate; Rebecca Collen; Hayley Billingsley; Leo Francis Buckley; Salvatore Carbone; Cory Ross Trankle; Michael Ola Idowu; Dinesh Kadariya; Benjamin Van Tassell; Arun Jayant Sanyal; Mohammad Shadab Siddiqui Journal: Am J Cardiol Date: 2018-11-06 Impact factor: 2.778
Authors: Laura S Chiu; Alison Pedley; Joseph M Massaro; Emelia J Benjamin; Gary F Mitchell; David D McManus; Jayashri Aragam; Ramachandran S Vasan; Susan Cheng; Michelle T Long Journal: Liver Int Date: 2020-07-25 Impact factor: 5.828