Cardiac structure and function are altered in adults with non-alcoholic fatty liver disease
Cardiac structure and function are altered in adults with non-alcoholic fatty liver disease
复制标题
DOI：
10.1016/j.jhep.2012.11.015
复制
发表时间：
2013-04-01
影响因子：
25.7
通讯作者：
Trenell, Michael I.
中科院分区：
文献类型：
--
作者：
Hallsworth, Kate;Hollingsworth, Kieren G.;Trenell, Michael I.
背景与目的：非酒精性脂肪性肝病（NAFLD）与心血管疾病的风险增加两倍相关。尽管如此，关于NAFLD对心脏功能的影响知之甚少，限制了我们确定治疗策略的能力。本研究旨在通过定义NAFLD对心脏功能、结构和代谢的影响来解决这一问题：19名NAFLD成人与无肝脏或代谢疾病的健康对照组进行年龄、性别和BMI匹配。使用高分辨率心脏MRI和3.0 T标记评估心脏结构和功能。高能磷酸盐代谢采用P-31-磁共振波谱法测量PCr/ATP比值进行评估。结果：NAFLD成人患者在收缩期左室壁明显增厚（14 +/- 3 vs. 12 +/- 2 mm; p < 0.01），（8 +/- 1对7 +/- 1 mm; p < 0.01），显示纵向缩短减少（14 +/- 3对17 +/- 3%; p < 0.01）。NAFLD组的偏心率显著更高（1.1 +/- 0.2对0.9 +/- 0.2 g/ml; p < 0.01），表明向心性重塑。NAFLD组的峰值全壁应变更高（19 +/- 2 vs. 17 +/- 3%; p < 0.01），峰值内皮细胞应变也是如此（28 +/- 4 vs. 22 +/- 5%; p < 0.01）。在NAFLD患者中，通过PCr/ATP比值测量的心脏代谢没有改变（1.8 +/- 0.3 vs. 1.9 +/- 0.3; p = 0.36）。结论：在明显没有代谢变化或明显心脏疾病的情况下，NAFLD成人的心脏结构和功能明显改变。临床医生应继续探索改善心脏功能的治疗方法，以改变与NAFLD相关的心血管疾病的过度风险。(C)2012年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with a twofold greater risk of developing cardiovascular disease. Despite this, little is known about the effect of NAFLD upon cardiac function, limiting our ability to identify therapeutic strategies. This study aimed to address this by defining the effect of NAFLD on cardiac function, structure, and metabolism.Methods: Nineteen adults with NAFLD were age-, sex-, and BMI-matched to healthy controls without liver or metabolic disease. Cardiac structure and function were assessed using high-resolution cardiac MRI and tagging at 3.0 T. High-energy phosphate metabolism was assessed using P-31-magnetic resonance spectroscopy to measure the PCr/ATP ratio.Results: Adults with NAFLD had significantly thicker left ventricular walls at systole (14 +/- 3 vs. 12 +/- 2 mm; p < 0.01) and diastole (8 +/- 1 vs. 7 +/- 1 mm; p < 0.01) than those without fatty liver and showed decreased longitudinal shortening (14 +/- 3 vs. 17 +/- 3%; p < 0.01). The eccentricity ratio was significantly higher in the NAFLD group (1.1 +/- 0.2 vs. 0.9 +/- 0.2 g/ml; p < 0.01) indicating concentric remodelling. Peak whole wall strain was higher in the NAFLD group (19 +/- 2 vs. 17 +/- 3%; p < 0.01), as was peak endocardial strain (28 +/- 4 vs. 22 +/- 5%; p < 0.01). Cardiac metabolism, measured by PCr/ATP ratio, was not altered in NAFLD (1.8 +/- 0.3 vs. 1.9 +/- 0.3; p = 0.36).Conclusions: Significant changes in cardiac structure and function are evident in adults with NAFLD in the apparent absence of metabolic changes or overt cardiac disease. Clinicians should continue to explore therapies to improve cardiac function as a means to modify the excess risk of cardiovascular disease associated with NAFLD. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.