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Nonalcoholic Steatohepatitis is Associated with Cardiac Remodeling and Dysfunction
Author(s) -
Simon Tracey G.,
Bamira Daniel G.,
Chung Raymond T.,
Weiner Rory B.,
Corey Kathleen E.
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21879
Subject(s) - medicine , cardiology , nonalcoholic fatty liver disease , body mass index , subclinical infection , cohort , diastole , perioperative , retrospective cohort study , mass index , heart failure , fatty liver , surgery , disease , blood pressure
Objective Preliminary data suggest that nonalcoholic fatty liver disease is associated with early heart failure (HF). However, whether nonalcoholic steatohepatitis (NASH) is directly associated with echocardiographic changes in cardiac structure or function remains unknown. Methods A retrospective cohort was identified of individuals ( N = 65) without known heart disease, undergoing elective bariatric surgery with perioperative liver biopsy, and available recent transthoracic echocardiography (TTE). TTE measures were evaluated by NASH status using correlation coefficients, ANOVA, and linear regression, accounting for cardiometabolic factors. Results Median age was 47 years; 22% ( n = 14) had NASH. NASH patients had increased median left atrial (LA) volume (28.6 mL/m 2 vs. 24.8 mL/m 2 ; P < 0.0001) and left ventricular (LV) mass (82.6 g/m 2 vs. 78.6 g/m 2 ; P < 0.0001), indexed for height. NASH was inversely correlated with indices of diastolic function, including septal E′ ( r = −0.90 [95% CI: −1.21 to −0.42]; P = 0.020) and E:A ( r = −0.31 [95% CI: −0.51 to −0.09]; P = 0.037). In adjusted analyses, NASH remained associated with increased LV mass index (ß 1 = 7.16 [SE: 4.95]; P = 0.001) and LA volume index (ß 1 = 0.19 [SE: 0.08]; P = 0.001) and reduced lateral and septal E′ (ß 1 = −0.91, P = 0.015; ß 1 = −0.89, P = 0.047, respectively). Conclusions In this bariatric cohort, NASH was associated with changes in myocardial structure and in load‐dependent indices of LV diastolic function, suggestive of subclinical HF.