Ateş Muhammet Salih, Sökmen Erdoğan
Department of Cardiology, Kırşehir Ahi Evran Training and Research Hospital, Kırşehir 40100, Turkey.
J Clin Med. 2025 Jul 1;14(13):4650. doi: 10.3390/jcm14134650.
: Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to cardiovascular complications, including atrial fibrillation. P-wave indices (PWIs) reflect atrial conduction heterogeneity but have not been fully evaluated in MAFLD. To compare PWIs in MAFLD patients versus controls, assess their association with fibrosis severity, and evaluate their diagnostic performance for MAFLD and fibrosis. : In this retrospective single-center study, 447 subjects were included (noMAFLD: Fatty Liver Index (FLI) < 30 without metabolic dysfunction, n = 205; MAFLD: FLI ≥ 60+ ≥ 1 metabolic risk factor, n = 242). Among MAFLD subjects, the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score (NFS) stratified lower (NFS ≤ -1.455; n = 170), and there was a higher fibrosis risk (NFS > -1.455; n = 72). Standard 12-lead ECGs were digitized for offline PWI measurement. Statistical analyzes included group comparisons, multivariable logistic regression, and ROC curve analysis. : MAFLD patients exhibited a longer PWPT-D2 (63 ± 12 vs. 52 ± 10 ms, = 0.003), PWPT-V1 (68 ± 14 vs. 60 ± 13 ms, = 0.005), PWdis (55 ± 13 vs. 46 ± 11 ms, = 0.010), and PTFV (38 [31-46] vs. 28 [22-34] mm·ms, = 0.021) compared with controls. Within MAFLD, a higher fibrosis risk was associated with a further PWI prolongation (all < 0.015). Multivariate analysis identified PWPT-D2 (OR 1.05 per ms; 95% CI 1.02-1.08; = 0.002) and PWDIS (OR 1.03 per ms; 95% CI 1.00-1.06; = 0.048) as independent MAFLD predictors. ROC curves showed PWPT-D2 had the highest AUC for MAFLD detection (0.78; 95% CI 0.72-0.84) and fibrosis (0.82; 95% CI 0.76-0.88). Combining PWPT-D2 with BMI and waist circumference improved MAFLD discrimination (AUC 0.89; 95% CI 0.85-0.93; < 0.001 vs. PWPT-D2 alone). : PWPT-D2 and PWdis are significantly prolonged in MAFLD and more so with advanced fibrosis. PWPT-D2 may be a simple, noninvasive ECG marker for MAFLD screening and fibrosis staging, particularly when combined with anthropometric measures.
代谢功能障碍相关脂肪性肝病（MAFLD）与包括心房颤动在内的心血管并发症有关。P波指标（PWIs）反映心房传导异质性，但在MAFLD中尚未得到充分评估。比较MAFLD患者与对照组的PWIs，评估其与纤维化严重程度的关联，并评估其对MAFLD和纤维化的诊断性能。：在这项回顾性单中心研究中，纳入了447名受试者（非MAFLD：脂肪肝指数（FLI）<30且无代谢功能障碍，n = 205；MAFLD：FLI≥60+≥1个代谢风险因素，n = 242）。在MAFLD受试者中，非酒精性脂肪性肝病（NAFLD）纤维化评分（NFS）分层较低（NFS≤-1.455；n = 170），纤维化风险较高（NFS>-1.455；n = 72）。对标准12导联心电图进行数字化处理以进行离线PWI测量。统计分析包括组间比较、多变量逻辑回归和ROC曲线分析。：与对照组相比，MAFLD患者的PWPT-D2（63±12 vs. 52±10 ms，P = 0.003）、PWPT-V1（68±14 vs. 60±13 ms，P = 0.005）、PWdis（55±13 vs. 46±11 ms，P = 0.010）和PTFV（38 [31 - 46] vs. 28 [22 - 34] mm·ms，P = 0.021）更长。在MAFLD中，更高的纤维化风险与PWI进一步延长相关（所有P<0.015）。多变量分析确定PWPT-D2（每毫秒OR 1.05；95%CI 1.02 - 1.08；P = 0.002）和PWdis（每毫秒OR 1.03；95%CI 1.00 - 1.
