Interatrial septal fat thickness and left atrial stiffness are mechanistic links between nonalcoholic fatty liver disease and incident atrial fibrillation.


Journal

Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187

Informations de publication

Date de publication:
02 2019
Historique:
received: 31 10 2018
revised: 16 11 2018
accepted: 18 11 2018
pubmed: 15 12 2018
medline: 6 6 2019
entrez: 15 12 2018
Statut: ppublish

Résumé

Recently, a clear evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident atrial fibrillation (AF). Yet, the underlying pathogenesis is speculative. Thereby, we aimed to investigate the hypothesis that, interatrial thickness (IAST) and left atrial stiffness (LASt) might have mechanistic links between NAFLD and AF. Echocardiography and speckle-tracking assessment of left atrial function, transient elastography (TE) of the liver, basal ECG, and Holter monitoring were performed in 180 patients with (NAFLD) and 80 subjects without NAFLD. Patients with NAFLD had higher values of IAST (P < 0.001), LASt (<0.001), and E/e' ratio (<0.003) compared with controls. IAST was correlated with LASt (r = 0.413; P < 0.001). 15.6% of patients with NAFLD had AF. More so, patients with increased IAST/LASt had a higher incidence of AF (25%) vs 3.8% in those with normal IAST/LASt. The LASt and IAST increased significantly in those with AF compared with those without (P < 0.001). Patients who experienced AF had higher values (P < 0.01) of TE (kPa). The degree of liver stiffness TE (kPa) was correlated with both IAST and LASt (r = 461, r = 0.535; P < 0.001). Furthermore, multivariate regression analysis showed that LASt and IAST were independent predictors of incident AF in subjects with NAFLD. Our data suggest that increased IAST and LASt index are independently associated with incident atrial fibrillation in patients with NAFLD. Increased IAST and LASt index might provide mechanistic links between NAFLD and incident atrial fibrillation.

Sections du résumé

BACKGROUND AND AIM
Recently, a clear evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of incident atrial fibrillation (AF). Yet, the underlying pathogenesis is speculative. Thereby, we aimed to investigate the hypothesis that, interatrial thickness (IAST) and left atrial stiffness (LASt) might have mechanistic links between NAFLD and AF.
METHODS
Echocardiography and speckle-tracking assessment of left atrial function, transient elastography (TE) of the liver, basal ECG, and Holter monitoring were performed in 180 patients with (NAFLD) and 80 subjects without NAFLD.
RESULTS
Patients with NAFLD had higher values of IAST (P < 0.001), LASt (<0.001), and E/e' ratio (<0.003) compared with controls. IAST was correlated with LASt (r = 0.413; P < 0.001). 15.6% of patients with NAFLD had AF. More so, patients with increased IAST/LASt had a higher incidence of AF (25%) vs 3.8% in those with normal IAST/LASt. The LASt and IAST increased significantly in those with AF compared with those without (P < 0.001). Patients who experienced AF had higher values (P < 0.01) of TE (kPa). The degree of liver stiffness TE (kPa) was correlated with both IAST and LASt (r = 461, r = 0.535; P < 0.001). Furthermore, multivariate regression analysis showed that LASt and IAST were independent predictors of incident AF in subjects with NAFLD.
CONCLUSIONS
Our data suggest that increased IAST and LASt index are independently associated with incident atrial fibrillation in patients with NAFLD. Increased IAST and LASt index might provide mechanistic links between NAFLD and incident atrial fibrillation.

Identifiants

pubmed: 30548700
doi: 10.1111/echo.14229
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

249-256

Informations de copyright

© 2018 Wiley Periodicals, Inc.

Auteurs

Ragab A Mahfouz (RA)

Cardiology Department, Zagazig University Hospital-Egypt, Zagazig, Egypt.

Mohammad Gouda (M)

Cardiology Department, Zagazig University Hospital-Egypt, Zagazig, Egypt.

Islam Galal (I)

Cardiology Department, Zagazig University Hospital-Egypt, Zagazig, Egypt.

Mohamed S Ghareb (MS)

Cardiology Department, Zagazig University Hospital-Egypt, Zagazig, Egypt.

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