Li Sha, Bo Kairui, Ma Wenshan, Li Weibo, Zhang Hong, Wang Hui, Xu Lei
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China.
Department of Radiology, Yidu Central Hospital of Shandong Second Medical University, Qingzhou, China.
Int J Cardiol. 2025 Dec 1;440:133709. doi: 10.1016/j.ijcard.2025.133709. Epub 2025 Aug 6.
Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to adverse cardiovascular outcomes in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Nonetheless, its impact on left ventricular dysfunction and myocardial strain in this population is yet to be elucidated. Therefore, this study aimed to determine the effect of MAFLD on left ventricular function and strain parameters in patients with ASTEMI using cardiac magnetic resonance (CMR).
This retrospective study included 318 patients with ASTEMI (113 MAFLD and 205 non-MAFLD) undergoing CMR and non-enhanced computed tomography. Left ventricular function, global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) were compared between the two groups. Univariate and multivariate linear regression analyses were performed to examine the effect of MAFLD on left ventricular function and global strain in patients with ASTEMI.
Patients with MAFLD demonstrated significantly lower left ventricular ejection fraction (LVEF) (53.35 % vs. 59.64 %, P < 0.001), left ventricular global function index (LVGFI) (27.24 vs. 29.23, P = 0.006), and reduced absolute values of global strain in all three directions (GRS: 16.90 % vs. 18.80 %; GCS: 11.90 % vs. 12.90 %; GLS: 8.80 % vs. 10.90 %; all P < 0.001). Multivariate analysis confirmed that MAFLD was an independent predictor of LVEF (β = -0.112, P = 0.028), LVGFI (β = - 0.109, P = 0.034), and multidirectional strain parameters (GRS, GCS, and GLS) (all P < 0.05). Moreover, increased MAFLD severity was correlated with a numerical deterioration in both left ventricular function parameters and global strain values.
MAFLD independently exacerbates left ventricular dysfunction and myocardial deformation in patients with ASTEMI, emphasizing its role in postinfarction risk stratification and management.
代谢功能障碍相关脂肪性肝病（MAFLD）与急性ST段抬高型心肌梗死（ASTEMI）患者的不良心血管结局相关。尽管如此，其对该人群左心室功能和心肌应变的影响尚待阐明。因此，本研究旨在使用心脏磁共振成像（CMR）确定MAFLD对ASTEMI患者左心室功能和应变参数的影响。
本回顾性研究纳入了318例接受CMR和非增强计算机断层扫描的ASTEMI患者（113例MAFLD患者和205例非MAFLD患者）。比较两组患者的左心室功能、整体径向应变（GRS）、整体圆周应变（GCS）和整体纵向应变（GLS）。进行单因素和多因素线性回归分析，以检验MAFLD对ASTEMI患者左心室功能和整体应变的影响。
MAFLD患者的左心室射血分数（LVEF）显著降低（53.35%对59.64%，P < 0.001），左心室整体功能指数（LVGFI）降低（27.24对29.23，P = 0.006），并且在所有三个方向上整体应变的绝对值均降低（GRS：16.90%对18.80%；GCS：11.90%对12.90%；GLS：8.80%对10.90%；所有P < 0.001）。多因素分析证实，MAFLD是LVEF（β = -0.112，P = 0.028）、LVGFI（β = -0.109，P = 0.034）和多方向应变参数（GRS、GCS和GLS）的独立预测因素（所有P < 0.05）。此外，MAFLD严重程度增加与左心室功能参数和整体应变值的数值恶化相关。
MAFLD独立加重ASTEMI患者的左心室功能障碍和心肌变形，强调了其在心肌梗死后风险分层和管理中的作用。
