Moise Cristiana Gianina, Donoiu Ionuţ, Târtea Georgică-Costinel, Mirea Oana, Rogoveanu Ion
Doctoral School, University of Medicine and Pharmacy of Craiova, Romania.
Department of Cardiology, University of Medicine and Pharmacy of Craiova, Romania.
Curr Health Sci J. 2021 Apr-Jun;47(2):275-283. doi: 10.12865/CHSJ.47.02.19. Epub 2021 Jun 30.
Non-alcoholic fatty liver disease affects about 30% of the population and it has a growing tendecy with the increasing incidence of obesity. Currently, a large amount of clinical evidence has shown that cardiovascular disease represents the main cause of mortality in patients suffering from non-alcoholic fatty liver disease.
In this study we investigated the structural and functional changes of the left ventricle in young adults with hepatic steatosis using modern echocardiographic techniques.
By using tissue Doppler imaging and also Speckle tracking echocardiography the left ventricle systolic function was assessed.
All patients included in the study had a normal left ventricular ejection fraction but, when the longitudinal function of the left ventricle was assessed using the tissue Doppler technique (maximum systolic velocity S) statistically significant differences were found in both the group of patients with non-alcoholic fatty liver as well as in the group of patients associated with diabetes. Using speckle tracking echocardiography, we found a statistically significant decrease of the global longitudinal strain in the endocardium, in the group of patients with non-alcoholic liver disease but also in the group of those with diabetes. The overall longitudinal strain at the myocardium was significantly reduced only in the group of patients with non-alcoholic fatty liver disease and diabetes, while the overall longitudinal strain at the epicardium showed no changes in any of the groups studied. Also, no changes were observed at the circumferential strain.
Non-alcoholic fatty liver disease, diagnosed in asymptomatic young adults may be a risk factor for remodeling the left ventricle over time, being associated with subclinical myocardial dysfunction, regardless of the presence of other cardiovascular risk factors.
非酒精性脂肪性肝病影响约30%的人口，且随着肥胖发病率的增加呈上升趋势。目前，大量临床证据表明，心血管疾病是患有非酒精性脂肪性肝病患者的主要死亡原因。
在本研究中，我们使用现代超声心动图技术研究了患有肝脂肪变性的年轻成年人左心室的结构和功能变化。
通过组织多普勒成像和斑点追踪超声心动图评估左心室收缩功能。
纳入研究的所有患者左心室射血分数均正常，但是，当使用组织多普勒技术（最大收缩速度S）评估左心室纵向功能时，在非酒精性脂肪性肝病患者组以及糖尿病相关患者组中均发现了统计学上的显著差异。使用斑点追踪超声心动图，我们发现非酒精性肝病患者组以及糖尿病患者组的心内膜整体纵向应变均有统计学上的显著降低。仅在非酒精性脂肪性肝病和糖尿病患者组中，心肌的整体纵向应变显著降低，而在心外膜的整体纵向应变在任何研究组中均未显示变化。此外，圆周应变也未观察到变化。
在无症状的年轻成年人中诊断出的非酒精性脂肪性肝病可能是随着时间推移左心室重塑的危险因素，与亚临床心肌功能障碍相关，无论是否存在其他心血管危险因素。
