Zhang Zichuan, Wang Peize, Guo Fei, Liu Xinmin, Luo Taiyang, Guan Yang, Chen Hui, Wang Zhanhong, Zhao L, Ma Xiaohai, Lv Qiang, Zhang Yin, Kang Junping, Liu Tong, Liu Xiaohui, Dong Jian-Zeng, Bai Rong
1 Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
2 Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
J Int Med Res. 2018 Sep;46(9):3959-3969. doi: 10.1177/0300060518782780. Epub 2018 Jul 3.
Objective This study was performed to assess the prevalence of nonalcoholic fatty liver (NAFL) in patients with symptomatic congestive heart failure (CHF) and compare the clinical features with those of patients without NAFL. Methods In total, 102 patients with CHF were divided into NAFL and non-NAFL groups according to their hepatic ultrasonography findings. All patients underwent transthoracic echocardiography and cardiac magnetic resonance examination. Follow-up was performed for major cardiovascular events (MACE) and readmission due to heart failure at 1, 3, 6, and 12 months after the index hospitalization. Results NAFL was detected in 37 of 102 patients (36.27%). Compared with the non-NAFL group, patients with NAFL were younger, had a higher body mass index and left ventricular (LV) mass index, and had more severe fibrosis. MACE and readmission occurred in 15 patients in the NAFL group and 29 patients in the non-NAFL group, without a significant difference. Linear regression analysis revealed that after adjusting for confounders, NAFL was independently associated with the LV fibrosis size and the ratio of the LV fibrosis size to the LV mass index. Conclusions NAFL is present in more than one-third of patients with CHF and is associated with the severity of LV fibrosis.
目的 本研究旨在评估有症状的充血性心力衰竭(CHF)患者中非酒精性脂肪性肝病(NAFL)的患病率,并将其临床特征与无NAFL的患者进行比较。方法 总共102例CHF患者根据肝脏超声检查结果分为NAFL组和非NAFL组。所有患者均接受经胸超声心动图和心脏磁共振检查。在首次住院后1、3、6和12个月对主要心血管事件(MACE)和因心力衰竭再次入院情况进行随访。结果 102例患者中有37例(36.27%)检测出NAFL。与非NAFL组相比,NAFL组患者更年轻,体重指数和左心室(LV)质量指数更高,纤维化更严重。NAFL组有15例患者发生MACE和再次入院,非NAFL组有29例患者发生,差异无统计学意义。线性回归分析显示,在调整混杂因素后,NAFL与LV纤维化大小以及LV纤维化大小与LV质量指数的比值独立相关。结论 超过三分之一的CHF患者存在NAFL,且与LV纤维化的严重程度相关。