High liver fibrosis scores in metabolic dysfunction-associated fatty liver disease patients are associated with adverse atrial remodeling and atrial fibrillation recurrence following catheter ablation.
MAFLD (metabolic associated fatty liver disease)
atrial fibrillation
atrial remodeling
catheter ablation
liver fibrosis
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2022
2022
Historique:
received:
30
05
2022
accepted:
01
08
2022
entrez:
19
9
2022
pubmed:
20
9
2022
medline:
21
9
2022
Statut:
epublish
Résumé
A number of epidemiological studies have suggested an association between metabolic dysfunction-associated fatty liver disease (MAFLD) and the incidence of atrial fibrillation (AF). However, the pathogenesis leading to AF in the context of MAFLD remains unclear. We therefore aimed at assessing the impact of MAFLD and liver fibrosis status on left atrium (LA) structure and function. Patients with a Fatty Liver Index (FLI) >60 and the presence of metabolic comorbidities were classified as MAFLD+. In MAFLD+ patients, liver fibrosis severity was defined using the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score (NFS), as follows: MAFLD w/o fibrosis (NFS ≦ -1.455), MAFLD w/indeterminate fibrosis (-1.455 < NFS < 0.675), and MAFLD w/fibrosis (NFS ≧ 0.675). In the first cohort of patients undergoing AF ablation, the structural and functional impact on LA of MAFLD was assessed by LA strain analysis and endocardial voltage mapping. Histopathological assessment of atrial fibrosis was performed in the second cohort of patients undergoing cardiac surgery. Finally, the impact of MAFLD on AF recurrence following catheter ablation was assessed. In the AF ablation cohort (NoMAFLD n = 123; MAFLD w/o fibrosis n = 37; MAFLD indeterm. fibrosis n = 75; MAFLD w/severe fibrosis n = 10), MAFLD patients with high risk of F3-F4 liver fibrosis presented more LA low-voltage areas as compared to patients without MAFLD (16.5 [10.25; 28] vs 5.0 [1; 11] low-voltage areas p = 0.0115), impaired LA reservoir function assessed by peak left atrial longitudinal strain (19.7% ± 8% vs 8.9% ± 0.89% p = 0.0268), and increased LA volume (52.9 ± 11.7 vs 43.5 ± 18.0 ml/m In conclusion, we found that liver fibrosis scoring in MAFLD patients is associated with adverse atrial remodeling and AF recurrences following catheter ablation. The impact of the management of MAFLD on LA remodeling and AF ablation outcomes should be assessed in dedicated studies.
Sections du résumé
Background
A number of epidemiological studies have suggested an association between metabolic dysfunction-associated fatty liver disease (MAFLD) and the incidence of atrial fibrillation (AF). However, the pathogenesis leading to AF in the context of MAFLD remains unclear. We therefore aimed at assessing the impact of MAFLD and liver fibrosis status on left atrium (LA) structure and function.
Methods
Patients with a Fatty Liver Index (FLI) >60 and the presence of metabolic comorbidities were classified as MAFLD+. In MAFLD+ patients, liver fibrosis severity was defined using the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score (NFS), as follows: MAFLD w/o fibrosis (NFS ≦ -1.455), MAFLD w/indeterminate fibrosis (-1.455 < NFS < 0.675), and MAFLD w/fibrosis (NFS ≧ 0.675). In the first cohort of patients undergoing AF ablation, the structural and functional impact on LA of MAFLD was assessed by LA strain analysis and endocardial voltage mapping. Histopathological assessment of atrial fibrosis was performed in the second cohort of patients undergoing cardiac surgery. Finally, the impact of MAFLD on AF recurrence following catheter ablation was assessed.
Results
In the AF ablation cohort (NoMAFLD n = 123; MAFLD w/o fibrosis n = 37; MAFLD indeterm. fibrosis n = 75; MAFLD w/severe fibrosis n = 10), MAFLD patients with high risk of F3-F4 liver fibrosis presented more LA low-voltage areas as compared to patients without MAFLD (16.5 [10.25; 28] vs 5.0 [1; 11] low-voltage areas p = 0.0115), impaired LA reservoir function assessed by peak left atrial longitudinal strain (19.7% ± 8% vs 8.9% ± 0.89% p = 0.0268), and increased LA volume (52.9 ± 11.7 vs 43.5 ± 18.0 ml/m
Conclusion
In conclusion, we found that liver fibrosis scoring in MAFLD patients is associated with adverse atrial remodeling and AF recurrences following catheter ablation. The impact of the management of MAFLD on LA remodeling and AF ablation outcomes should be assessed in dedicated studies.
Identifiants
pubmed: 36120456
doi: 10.3389/fendo.2022.957245
pmc: PMC9471263
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
957245Informations de copyright
Copyright © 2022 Decoin, Butruille, Defrancq, Robert, Destrait, Coisne, Aghezzaf, Woitrain, Gouda, Schino, Klein, Maboudou, Brigadeau, Klug, Vincentelli, Dombrowicz, Staels, Montaigne and Ninni.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Clin Gastroenterol Hepatol. 2013 Sep;11(9):1201-4
pubmed: 23353640
PLoS One. 2019 Nov 8;14(11):e0225008
pubmed: 31703113
J Cardiovasc Electrophysiol. 2014 Oct;25(10):1044-52
pubmed: 24832482
J Am Heart Assoc. 2022 Mar 15;11(6):e024521
pubmed: 35261287
J Gastroenterol Hepatol. 2022 Jun 24;:
pubmed: 35748302
J Am Coll Cardiol. 2017 Aug 8;70(6):756-765
pubmed: 28774383
Cardiovasc Res. 2021 Jun 16;117(7):1-21
pubmed: 33913486
Nat Commun. 2013;4:2823
pubmed: 24264436
Europace. 2020 Mar 1;22(3):342-351
pubmed: 31998939
J Am Coll Cardiol. 2013 Oct 15;62(16):1466-73
pubmed: 23644086
Int J Cardiol. 2015 Apr 1;184:597-599
pubmed: 25769006
Am J Cardiol. 2011 May 15;107(10):1498-503
pubmed: 21414593
Int J Cardiol. 2018 Apr 15;257:97-101
pubmed: 29506746
Int J Stroke. 2019 Feb;14(2):207-214
pubmed: 30196789
Liver Int. 2020 Jun;40(6):1254-1261
pubmed: 32301554
Clin Sci (Lond). 2013 Sep;125(6):301-9
pubmed: 23596966
Hypertens Res. 2015 Nov;38(11):758-64
pubmed: 26178155
J Atr Fibrillation. 2012 Oct 06;5(3):647
pubmed: 28496775
Hepatology. 2016 Jul;64(1):73-84
pubmed: 26707365
Gut. 2020 Sep;69(9):1691-1705
pubmed: 32321858
World J Gastroenterol. 2013 Feb 28;19(8):1219-29
pubmed: 23482703
Lancet. 2005 Sep 24-30;366(9491):1059-62
pubmed: 16182882
Circ Res. 2021 May 28;128(11):1747-1765
pubmed: 34043417
Diabetologia. 2016 Jan;59(1):30-43
pubmed: 26407715
J Mol Cell Cardiol. 2016 Apr;93:149-55
pubmed: 26593722
J Hepatol. 2016 Jun;64(6):1388-402
pubmed: 27062661
Am J Cardiol. 2013 Jan 15;111(2):219-24
pubmed: 23127690
Gastroenterology. 2020 May;158(7):1999-2014.e1
pubmed: 32044314
Eur Heart J. 2016 Oct 7;37(38):2893-2962
pubmed: 27567408
J Arrhythm. 2016 Aug;32(4):247-78
pubmed: 27588148
Circulation. 2008 Mar 11;117(10):1255-60
pubmed: 18285562
Am J Pathol. 1995 Aug;147(2):325-38
pubmed: 7639329
Nat Rev Gastroenterol Hepatol. 2017 Jul;14(7):397-411
pubmed: 28487545
J Am Coll Cardiol. 2010 Aug 31;56(10):784-8
pubmed: 20797492
J Am Coll Cardiol. 2015 May 26;65(20):2159-69
pubmed: 25792361
PLoS One. 2015 Nov 16;10(11):e0142937
pubmed: 26571029
Heart Rhythm. 2014 Mar;11(3):352-7
pubmed: 24252289
J Am Coll Cardiol. 2011 Apr 26;57(17):1745-51
pubmed: 21511110
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
Front Physiol. 2018 Dec 06;9:1670
pubmed: 30574091
Nat Rev Gastroenterol Hepatol. 2018 Jul;15(7):425-439
pubmed: 29713021
Heart Rhythm O2. 2020 May 18;1(2):147-159
pubmed: 34113869
Eur Heart J. 2021 Sep 21;42(36):3599-3726
pubmed: 34447992
Cardiovasc Res. 2021 Dec 31;:
pubmed: 34971360
J Hepatol. 2012 Aug;57(2):399-420
pubmed: 22633836
World J Gastroenterol. 2021 Sep 14;27(34):5753-5763
pubmed: 34629799
J Am Coll Cardiol. 2022 Jan 18;79(2):180-191
pubmed: 35027111
Front Cardiovasc Med. 2022 Mar 23;9:832023
pubmed: 35402530
Hepatology. 2021 Nov;74(5):2839-2847
pubmed: 34309877
PLoS One. 2013;8(2):e57183
pubmed: 23451184
BMC Gastroenterol. 2006 Nov 02;6:33
pubmed: 17081293
Europace. 2018 Nov 1;20(FI_3):f359-f365
pubmed: 29016757
JACC Clin Electrophysiol. 2020 Oct;6(10):1278-1287
pubmed: 33092755
Eur Heart J. 2015 Apr 1;36(13):795-805a
pubmed: 23525094
Hepatology. 2007 Apr;45(4):846-54
pubmed: 17393509
Trends Endocrinol Metab. 2019 Dec;30(12):891-902
pubmed: 31630897
Expert Rev Cardiovasc Ther. 2013 Feb;11(2):155-60
pubmed: 23405837
Circulation. 2003 Nov 18;108(20):2460-6
pubmed: 14581396
Circ Arrhythm Electrophysiol. 2010 Aug;3(4):345-50
pubmed: 20558845
Europace. 2009 Dec;11(12):1597-605
pubmed: 19910315
J Am Soc Echocardiogr. 2014 May;27(5):463-78
pubmed: 24656882
Mol Metab. 2020 Dec;42:101092
pubmed: 33010471
Blood Press. 2014 Jun;23(3):147-53
pubmed: 24011171
JAMA. 2019 Apr 2;321(13):1261-1274
pubmed: 30874766
Diabetol Metab Syndr. 2022 Mar 22;14(1):44
pubmed: 35317824
Circulation. 1995 Oct 1;92(7):1954-68
pubmed: 7671380