Open AccessNonalcoholic fatty liver disease and atrial fibrillation: possible pathophysiological links and therapeutic interventions
Author(s) -
Hossein Haghbin,
Manesh Kumar Gangwani,
Shri Jai Kirshan Ravi,
Abhilash Perisetti,
Muhammad Aziz,
Hemant Goyal,
Ali Nawras,
Thomas Sodeman
Publication year - 2020
Publication title -
annals of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 33
eISSN - 1792-7463
pISSN - 1108-7471
DOI - 10.20524/aog.2020.0550
Subject(s) - medicine , nonalcoholic fatty liver disease , atrial fibrillation , dyslipidemia , pathophysiology , insulin resistance , epidemiology , metformin , disease , fatty liver , bioinformatics , insulin , biology
Atrial fibrillation (AF) and nonalcoholic fatty liver disease (NAFLD) share common risk factors and appear to have an association. Independently, the incidence and prevalence of both diseases are on the rise. Epidemiological evidence, experimental studies and various randomized clinical trials suggest a link between the 2 entities, delineating cumulative risks and clinical strategies to improve outcomes. Dyslipidemia, insulin resistance, inflammatory milieu, and activation of the renin-angiotensin system are likely common pathophysiological mechanisms linking AF and NAFLD. In this article we review the known pathways and pathophysiology that link the 2 conditions. This review also discusses therapies that target both NAFLD and AF, such as angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, metformin, and vitamin E. We further discuss other potential medications that have shown effects in NAFLD or AF through anti-inflammatory, antidiabetic, lipid-lowering, or renin-angiotensin system inhibiting effects. Future epidemiological studies are needed to establish a direct causal relationship between NAFLD and AF.