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

Lookup NU author(s): Dr Kate HallsworthORCiD, Dr Kieren Hollingsworth, Dr Christian Thoma, Professor Djordje JakovljevicORCiD, Dr Guy MacGowanORCiD, Professor Quentin AnsteeORCiD, Professor Roy Taylor, Professor Chris Day, Professor Mike TrenellORCiD


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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.

Publication metadata

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

Publication type: Article

Publication status: Published

Journal: Journal of Hepatology

Year: 2013

Volume: 58

Issue: 4

Pages: 757-762

Print publication date: 01/04/2013

Online publication date: 22/11/2012

Acceptance date: 07/11/2012

ISSN (print): 0168-8278

ISSN (electronic): 1600-0641

Publisher: Elsevier


DOI: 10.1016/j.jhep.2012.11.015


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Funder referenceFunder name
'Fatty Liver Inhibition of Progression' (FLIP) project
National Institute for Health Research Biomedical Research Centre on Ageing & Age Related Diseases
Diabetes UK
Higher Education Funding Council for England (HEFCE)
Medical Research Council
MRC Centre for Brain Ageing Vitality
National Institute for Health Research
Health-F2-2009-241762European Union