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Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease

PURPOSE: The constitutive elements of the metabolic syndrome (MetS) are linked with both non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. Controlled attenuation parameter (CAP), and vibration controlled transient elastography (VCTE), are able to detect and quantify NAFLD, while...

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Autores principales: Parvanescu, Tudor, Vitel, Andrei, Sporea, Ioan, Mare, Ruxandra, Buz, Bogdan, Bordejevic, Diana Aurora, Tomescu, Mirela Cleopatra, Arnautu, Sergiu Florin, Morariu, Vlad Ioan, Citu, Ioana Mihaela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043791/
https://www.ncbi.nlm.nih.gov/pubmed/33859484
http://dx.doi.org/10.2147/DMSO.S300450
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author Parvanescu, Tudor
Vitel, Andrei
Sporea, Ioan
Mare, Ruxandra
Buz, Bogdan
Bordejevic, Diana Aurora
Tomescu, Mirela Cleopatra
Arnautu, Sergiu Florin
Morariu, Vlad Ioan
Citu, Ioana Mihaela
author_facet Parvanescu, Tudor
Vitel, Andrei
Sporea, Ioan
Mare, Ruxandra
Buz, Bogdan
Bordejevic, Diana Aurora
Tomescu, Mirela Cleopatra
Arnautu, Sergiu Florin
Morariu, Vlad Ioan
Citu, Ioana Mihaela
author_sort Parvanescu, Tudor
collection PubMed
description PURPOSE: The constitutive elements of the metabolic syndrome (MetS) are linked with both non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. Controlled attenuation parameter (CAP), and vibration controlled transient elastography (VCTE), are able to detect and quantify NAFLD, while conventional and two-dimensional speckle tracking echocardiography (2D-STE) is capable to identify subclinical changes in cardiac function. We wanted to evaluate whether there is any correspondence between left ventricular (LV) diastolic dysfunction and different degrees of liver steatosis and fibrosis in MetS subjects with NAFLD. PATIENTS AND METHODS: A total of 150 adult subjects having MetS and a normal left ventricular (LV) systolic function were recorded in the study, while 150 age- and sex- matched adults without MetS were enrolled as controls. NAFLD was established by VCTE and CAP. The left heart systolic and diastolic function was evaluated by conventional and 2D-ST echocardiography. Left atrial (LA) stiffness was calculated as the ratio between the E/A ratio and the LA reservoir-strain. RESULTS: In univariate regression analysis, the variables associated with LV diastolic dysfunction in MetS patients were: liver steatosis grade ≥2, liver fibrosis grade ≥2, the longitudinal LA peak strain during the reservoir phase, the LA strain rate during ventricular contraction and the LA stiffness. In multivariate logistic regression, two variables were selected as independent predictors of LV diastolic dysfunction, namely the liver stiffness (P=0.0003) and the LA stiffness (P<0.0001). LA stiffness predicted subclinical LV diastolic dysfunction in MetS patients with a sensitivity of 45% and a specificity of 96% when using a cut-off value >0.38, and was significantly correlated with liver steatosis stage ≥2 and liver fibrosis stage ≥2. CONCLUSION: The present study confirms the association between liver stiffness, LA stiffness and LV diastolic dysfunction in MetS patients. Our study suggests that liver elastography and 2D-STE should become habitual assessments in MetS patients.
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spelling pubmed-80437912021-04-14 Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease Parvanescu, Tudor Vitel, Andrei Sporea, Ioan Mare, Ruxandra Buz, Bogdan Bordejevic, Diana Aurora Tomescu, Mirela Cleopatra Arnautu, Sergiu Florin Morariu, Vlad Ioan Citu, Ioana Mihaela Diabetes Metab Syndr Obes Original Research PURPOSE: The constitutive elements of the metabolic syndrome (MetS) are linked with both non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. Controlled attenuation parameter (CAP), and vibration controlled transient elastography (VCTE), are able to detect and quantify NAFLD, while conventional and two-dimensional speckle tracking echocardiography (2D-STE) is capable to identify subclinical changes in cardiac function. We wanted to evaluate whether there is any correspondence between left ventricular (LV) diastolic dysfunction and different degrees of liver steatosis and fibrosis in MetS subjects with NAFLD. PATIENTS AND METHODS: A total of 150 adult subjects having MetS and a normal left ventricular (LV) systolic function were recorded in the study, while 150 age- and sex- matched adults without MetS were enrolled as controls. NAFLD was established by VCTE and CAP. The left heart systolic and diastolic function was evaluated by conventional and 2D-ST echocardiography. Left atrial (LA) stiffness was calculated as the ratio between the E/A ratio and the LA reservoir-strain. RESULTS: In univariate regression analysis, the variables associated with LV diastolic dysfunction in MetS patients were: liver steatosis grade ≥2, liver fibrosis grade ≥2, the longitudinal LA peak strain during the reservoir phase, the LA strain rate during ventricular contraction and the LA stiffness. In multivariate logistic regression, two variables were selected as independent predictors of LV diastolic dysfunction, namely the liver stiffness (P=0.0003) and the LA stiffness (P<0.0001). LA stiffness predicted subclinical LV diastolic dysfunction in MetS patients with a sensitivity of 45% and a specificity of 96% when using a cut-off value >0.38, and was significantly correlated with liver steatosis stage ≥2 and liver fibrosis stage ≥2. CONCLUSION: The present study confirms the association between liver stiffness, LA stiffness and LV diastolic dysfunction in MetS patients. Our study suggests that liver elastography and 2D-STE should become habitual assessments in MetS patients. Dove 2021-04-09 /pmc/articles/PMC8043791/ /pubmed/33859484 http://dx.doi.org/10.2147/DMSO.S300450 Text en © 2021 Parvanescu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Parvanescu, Tudor
Vitel, Andrei
Sporea, Ioan
Mare, Ruxandra
Buz, Bogdan
Bordejevic, Diana Aurora
Tomescu, Mirela Cleopatra
Arnautu, Sergiu Florin
Morariu, Vlad Ioan
Citu, Ioana Mihaela
Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease
title Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease
title_full Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease
title_fullStr Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease
title_full_unstemmed Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease
title_short Significant Association Between Left Ventricular Diastolic Dysfunction, Left Atrial Performance and Liver Stiffness in Patients with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease
title_sort significant association between left ventricular diastolic dysfunction, left atrial performance and liver stiffness in patients with metabolic syndrome and non-alcoholic fatty liver disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043791/
https://www.ncbi.nlm.nih.gov/pubmed/33859484
http://dx.doi.org/10.2147/DMSO.S300450
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