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Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction
Insulin resistance and altered energy metabolism is common in non-alcoholic fatty liver disease (NAFLD) and appears to also be associated with myocardial dysfunction. We aimed to evaluate prevalence, staging and clinical features correlated with NAFLD among patients with heart failure with preserved...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381602/ https://www.ncbi.nlm.nih.gov/pubmed/32709942 http://dx.doi.org/10.1038/s41598-020-69013-y |
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author | Miller, Alexandria McNamara, Jennifer Hummel, Scott L. Konerman, Matthew C. Tincopa, Monica A. |
author_facet | Miller, Alexandria McNamara, Jennifer Hummel, Scott L. Konerman, Matthew C. Tincopa, Monica A. |
author_sort | Miller, Alexandria |
collection | PubMed |
description | Insulin resistance and altered energy metabolism is common in non-alcoholic fatty liver disease (NAFLD) and appears to also be associated with myocardial dysfunction. We aimed to evaluate prevalence, staging and clinical features correlated with NAFLD among patients with heart failure with preserved ejection fraction (HFpEF). Adults with HFpEF were prospectively enrolled. Demographic and clinical data were collected. NAFLD was defined based on liver biopsy, abdominal imaging or ICD-coding and the absence of other liver diseases. Descriptive, bivariate and multivariable analyses were performed. 181 patients were analyzed. The median age was 70 with 89% white, 59% female, median BMI 35.1, and 48% with diabetes. NAFLD was present in 27% of the full cohort and 50% of those with imaging. In patients with imaging, multivariable analysis identified diabetes (OR 3.38, 95% CI 1.29–8.88) and BMI (OR 1.11, 95% CI 1.04–1.19) as independent correlates of NAFLD. 54% of NAFLD patients had a NAFLD fibrosis score consistent with advanced fibrosis. Cirrhosis was present in 6.6% of patients overall and 11.5% with imaging. NAFLD patients had a higher frequency of advanced heart failure (75% vs 55%, p 0.01). NAFLD has a two-fold higher prevalence in HFpEF compared to the general population and is independently associated with BMI and diabetes. Patients with HFpEF and NAFLD also appeared to have more advanced fibrosis including cirrhosis suggesting a potential synergistic effect of cardiac dysfunction on fibrosis risk in NAFLD. This data supports consideration for evaluation of underlying liver disease in HFpEF patients. |
format | Online Article Text |
id | pubmed-7381602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-73816022020-07-28 Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction Miller, Alexandria McNamara, Jennifer Hummel, Scott L. Konerman, Matthew C. Tincopa, Monica A. Sci Rep Article Insulin resistance and altered energy metabolism is common in non-alcoholic fatty liver disease (NAFLD) and appears to also be associated with myocardial dysfunction. We aimed to evaluate prevalence, staging and clinical features correlated with NAFLD among patients with heart failure with preserved ejection fraction (HFpEF). Adults with HFpEF were prospectively enrolled. Demographic and clinical data were collected. NAFLD was defined based on liver biopsy, abdominal imaging or ICD-coding and the absence of other liver diseases. Descriptive, bivariate and multivariable analyses were performed. 181 patients were analyzed. The median age was 70 with 89% white, 59% female, median BMI 35.1, and 48% with diabetes. NAFLD was present in 27% of the full cohort and 50% of those with imaging. In patients with imaging, multivariable analysis identified diabetes (OR 3.38, 95% CI 1.29–8.88) and BMI (OR 1.11, 95% CI 1.04–1.19) as independent correlates of NAFLD. 54% of NAFLD patients had a NAFLD fibrosis score consistent with advanced fibrosis. Cirrhosis was present in 6.6% of patients overall and 11.5% with imaging. NAFLD patients had a higher frequency of advanced heart failure (75% vs 55%, p 0.01). NAFLD has a two-fold higher prevalence in HFpEF compared to the general population and is independently associated with BMI and diabetes. Patients with HFpEF and NAFLD also appeared to have more advanced fibrosis including cirrhosis suggesting a potential synergistic effect of cardiac dysfunction on fibrosis risk in NAFLD. This data supports consideration for evaluation of underlying liver disease in HFpEF patients. Nature Publishing Group UK 2020-07-24 /pmc/articles/PMC7381602/ /pubmed/32709942 http://dx.doi.org/10.1038/s41598-020-69013-y Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Miller, Alexandria McNamara, Jennifer Hummel, Scott L. Konerman, Matthew C. Tincopa, Monica A. Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
title | Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
title_full | Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
title_fullStr | Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
title_full_unstemmed | Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
title_short | Prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
title_sort | prevalence and staging of non-alcoholic fatty liver disease among patients with heart failure with preserved ejection fraction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381602/ https://www.ncbi.nlm.nih.gov/pubmed/32709942 http://dx.doi.org/10.1038/s41598-020-69013-y |
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