3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
1st Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Int J Mol Sci. 2023 Sep 19;24(18):14292. doi: 10.3390/ijms241814292.
The cardiovascular implications of non-alcoholic fatty liver disease (NAFLD) have been associated with heart failure with preserved ejection fraction (HFpEF). The purpose of this review was to conduct a bibliographic search regarding the correlation between NAFLD and the echocardiographic parameters of left ventricular diastolic function. A systematic literature search was conducted in PubMed and Embase for original research data reporting on the association of NAFLD with diastolic function markers [E/e', left atrial volume index (LAVi), left ventricular mass index (LVMi)]. Meta-analysis was performed using the meta and dmetar packages in R studio v.1.4.1106, with < 0.05 values being considered significant. Results are expressed as the standardized mean difference (SMD) for continuous variables and as the odds ratio (OR) for categorical variables, with respective 95% confidence intervals (CI). Heterogeneity between studies was expressed with index Ι. From the preliminary search, 2619 articles were found from which 31 studies were included in the final statistical analysis. The meta-analysis of 8 studies which reported on the prevalence of diastolic dysfunction showed that it was increased in patients with NAFLD (OR: 2.07, 95% CI 1.24-3.44 with = 0.01, I: 80% with < 0.01). The meta-analysis of 21 studies showed significantly higher E/e' in NAFLD patients (SMD 1.02, 95% CI 0.43-1.61 with < 0.001, I: 97% with < 0.001). Individuals with NAFLD had increased LAVi (SMD: 0.87, 95% CI 0.38-1.37 with < 0.001, I: 96% with < 0.001) and LVMi (SMD: 0.89, 95% CI 0.31-1.48 with = 0.003, I: 100% with < 0.001). To conclude, in the meta-analysis of 31 observational studies, NAFLD patients were found to have affected left ventricular diastolic function, supporting the hypothesis of NAFLD being associated with HFpEF.
非酒精性脂肪肝（NAFLD）与心力衰竭射血分数保留型（HFpEF）的心血管影响有关。本综述的目的是对非酒精性脂肪肝与左心室舒张功能的超声心动图参数之间相关性进行文献检索。在 PubMed 和 Embase 中进行了系统的文献检索，以获取报告非酒精性脂肪肝与舒张功能标志物[E/e'、左心房容积指数（LAVi）、左心室质量指数（LVMi）]相关性的原始研究数据。使用 R studio v.1.4.1106 中的 meta 和 dmetar 包进行荟萃分析， < 0.05 被认为具有统计学意义。结果以连续变量的标准化均数差（SMD）和分类变量的比值比（OR）表示，各自的 95%置信区间（CI）。研究间的异质性用指数 Ι 表示。从初步检索中，共找到 2619 篇文章，其中 31 篇研究纳入最终的统计分析。对 8 项报告舒张功能障碍患病率的研究进行荟萃分析显示，NAFLD 患者的舒张功能障碍患病率增加（OR：2.07，95%CI 1.24-3.44， = 0.01，I：80%， < 0.01）。对 21 项研究进行荟萃分析显示，NAFLD 患者的 E/e'显著升高（SMD 1.02，95%CI 0.43-1.61， < 0.001，I：97%， < 0.001）。NAFLD 患者的左心房容积指数（LAVi）增加（SMD：0.87，95%CI 0.38-1.37， < 0.001，I：96%， < 0.001）和左心室质量指数（LVMi）增加（SMD：0.89，95%CI 0.31-1.48， = 0.003，I：100%， < 0.001）。总之，在 31 项观察性研究的荟萃分析中，发现 NAFLD 患者的左心室舒张功能受到影响，支持非酒精性脂肪肝与 HFpEF 相关的假说。
