Mohammad R Ostovaneh1, Bharath Ambale-Venkatesh2, Tomoki Fuji1, Hooman Bakhshi1, Ravi Shah1, Venkatesh L Murthy1, Russell P Tracy1, Eliseo Guallar1, Colin O Wu1, David A Bluemke1, João A C Lima1. 1. From the Depatrment of Cardiology (M.R.O., T.F., H.B., E.G., J.A.C.L.) and the Department of Radiology (B.A.V.), Johns Hopkins University, Baltimore, MD; Department of Medicine, Harvard University, Boston, MA (R.S.); Department of Medicine, University of Michigan, Ann Arbor (V.L.M.); Department of Pathology and Laboratory Medicine, University of Vermont, Colchester (R.P.T.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.O.W.); and Department of Radiology, University of Wisconsin, Madison (D.A.B.). 2. From the Depatrment of Cardiology (M.R.O., T.F., H.B., E.G., J.A.C.L.) and the Department of Radiology (B.A.V.), Johns Hopkins University, Baltimore, MD; Department of Medicine, Harvard University, Boston, MA (R.S.); Department of Medicine, University of Michigan, Ann Arbor (V.L.M.); Department of Pathology and Laboratory Medicine, University of Vermont, Colchester (R.P.T.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.O.W.); and Department of Radiology, University of Wisconsin, Madison (D.A.B.). bambale1@jhmi.edu.
Abstract
BACKGROUND: The association of cardiovascular diseases (CVD) with liver fibrosis is poorly understood. We aim to assess the association of liver fibrosis by T1-mapping magnetic resonance imaging and CVD in MESA (Multi-Ethnic Study of Atherosclerosis). METHODS AND RESULTS: MESA enrolled 6814 participants free of clinical CVD at baseline (2000-2002). A subsample of participants underwent T1-mapping magnetic resonance imaging 10 years after the baseline (Y10 MESA exam, 2010-2012). Liver T1 maps were generated avoiding vessels and biliary ducts from which native T1 (n=2087) and extracellular volume fraction (ECV, n=1234) were determined. Higher ECV and native T1 were indicators of liver fibrosis. Linear regression analysis evaluated the cross-sectional relationship between liver native T1 and ECV at Y10 MESA exam with a history of CVD events (atrial fibrillation, heart failure, and coronary heart disease [CHD]). Of the 2087 participants (68.7±9.1 years; 46% females), 153 had prior CVD events (78 atrial fibrillation, 25 heart failure, and 78 CHD). History of CVD events was associated with 18.5 ms higher liver native T1 (P<0.001) and 1.4% greater ECV (P=0.06). Prior atrial fibrillation was related to higher liver native T1 (β=21.1; P=0.001) and greater ECV (β=2.2; P=0.02), whereas previous heart failure was associated with greater liver ECV (β=4.1; P=0.02). There was also a relationship of prior CHD with liver native T1 (β=13; P=0.05) and ECV (β=1.9; P=0.05), which was attenuated by adjustment for coronary artery calcium score (β=7.1 and 1.6; P=0.37 and 0.13, respectively). CONCLUSIONS: Liver fibrosis by T1-mapping magnetic resonance imaging is associated with history of heart failure, atrial fibrillation, and CHD in a multiethnic cohort. The association of liver fibrosis and CHD is at least in part mediated by atherosclerosis.
BACKGROUND: The association of cardiovascular diseases (CVD) with liver fibrosis is poorly understood. We aim to assess the association of liver fibrosis by T1-mapping magnetic resonance imaging and CVD in MESA (Multi-Ethnic Study of Atherosclerosis). METHODS AND RESULTS:MESA enrolled 6814 participants free of clinical CVD at baseline (2000-2002). A subsample of participants underwent T1-mapping magnetic resonance imaging 10 years after the baseline (Y10 MESA exam, 2010-2012). Liver T1 maps were generated avoiding vessels and biliary ducts from which native T1 (n=2087) and extracellular volume fraction (ECV, n=1234) were determined. Higher ECV and native T1 were indicators of liver fibrosis. Linear regression analysis evaluated the cross-sectional relationship between liver native T1 and ECV at Y10 MESA exam with a history of CVD events (atrial fibrillation, heart failure, and coronary heart disease [CHD]). Of the 2087 participants (68.7±9.1 years; 46% females), 153 had prior CVD events (78 atrial fibrillation, 25 heart failure, and 78 CHD). History of CVD events was associated with 18.5 ms higher liver native T1 (P<0.001) and 1.4% greater ECV (P=0.06). Prior atrial fibrillation was related to higher liver native T1 (β=21.1; P=0.001) and greater ECV (β=2.2; P=0.02), whereas previous heart failure was associated with greater liver ECV (β=4.1; P=0.02). There was also a relationship of prior CHD with liver native T1 (β=13; P=0.05) and ECV (β=1.9; P=0.05), which was attenuated by adjustment for coronary artery calcium score (β=7.1 and 1.6; P=0.37 and 0.13, respectively). CONCLUSIONS:Liver fibrosis by T1-mapping magnetic resonance imaging is associated with history of heart failure, atrial fibrillation, and CHD in a multiethnic cohort. The association of liver fibrosis and CHD is at least in part mediated by atherosclerosis.
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