Publication:

Cardiac structure and function are altered in adults with non-alcoholic fatty liver disease (2013)

Author(s): Hallsworth K, Hollingsworth KG, Thoma C, Jakovljevic DG, MacGowan GA, Anstee QM, Taylor R, Day CP, Trenell MI

    Abstract: 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 31P-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.

      • Date: 22-11-2012
      • Journal: Journal of Hepatology
      • Volume: 58
      • Issue: 4
      • Pages: 757-762
      • Publisher: Elsevier
      • Publication type: Article
      • Bibliographic status: Published

      Keywords: NAFLD; Cardiovascular disease; Imaging; Cardiac function

      Staff

      Dr Quentin Anstee
      Clinical Senior Lecturer & Consultant Hepatologist

      Professor Chris Day
      PVC/Provost of Medical Sciences

      Kate Hallsworth
      Physiotherapist

      Dr Kieren Hollingsworth
      Lecturer in Magnetic Resonance Physics

      Professor Roy Taylor
      Director of Newcastle Magnetic Resonance Centre

      Professor Michael Trenell
      NIHR Senior Research Fellow & Director, MoveLab; Physical Activity & Exercise Research