PREDICTION OF LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEART FAILURE AND METABOLIC SYNDROME
Abstract
Currently, the non-alcoholic fatty liver disease (NAFLD) is recognized as the most common chronic liver disease. 27.8% of patients with NAFLD have diseases of the cardiovascular system (cardiovascular), which are the leading cause of death in patients with NAFLD. Objective: To study the probability of liver fibrosis in patients with metabolic syndrome and chronic heart failure (CHF). Materials and Methods: The study included 77 patients with CHF. The diagnosis of CHF was confirmed by the qualitative measurement of NT-proBNP. The severity of the clinical manifestations of heart failure, functional status of the patient was assessed. All patients underwent clinical and biochemical blood tests, ECG, ultrasound examination of the liver. The size of the heart chambers, wall thickness of the myocardium and epicardial fat were evaluated by echocardiography. The NAFLD Fibrosis Score (NFS) was calculated in all patients enrolled in the study. Results: In the study group patients The direct correlations between the value of NFS: weight (r = 0,38; p = 0,001), glucose levels (r = 0,54; p = 0,001), the level of glycosylated hemoglobin (r = 0,51; p = 0,002), LV myocardium mass (r = 0, 51; p = 0,005), the sizes of the right atrium (RA) (r = 0,45; p = 0,013), sizes of the left atrium (LA) (r = 0,41; p = 0,023) were found in the study group patients. Inverse correlation between the value of NFS: total cholesterol (r = -0,43; p = 0,008), epicardial fat thickness (EFT) (r = 0,29; p = 0,014), end-diastolic (CD) left ventricular size (r = 0,27; p = 0,02), end-systolic (CS), left ventricular size (r = 0,27; p = 0,02), CD ventricular volume (r = 0,25; p = 0,02), CS LV volume (r = 0,28; p = 0,02). NFS is correlated with the six-minute walk test (6MWT) (p = 0,023; U-Mann-Whitney). Using the NAFLD fibrosis score in internist routine practice help to identify patients with NAFLD and cardiovascular diseases by non-invasive way in the early stages of the disease and to adjust the current treatment, if necessary.
About the Authors
O. M. Drapkina
National Research Center for Preventive Medicine
Russian Federation
Russian Federation
E. V. Zyatenkova
The first MSMU, named after I. M. Sechenov
Russian Federation
Russian Federation
References
1. Драпкина О. М. Алгоритм действий врача общей практики с целью выявления неалкогольной жировой болезни печени: Справочник поликлинического врача 2014; 09:28-31 (rus).
2. Drapkina O. M. Management algorithm of general practitioner for detection of non-alcoholic fatty liver disease: guide for outpatient practitioners 2014; 09:28-31.
3. Ивашкин В. Т., Драпкина О. М., Маев И. В., Трухманов А. С., Блинов Д. В., Пальгова Л. К., Ушакова Т. И. Распространенность неалкогольной жировой болезни печени у пациентов амбулаторно-поликлинической практики в российской федерации: результаты исследования DIREG 2. РЖГГК. 2015;6: 31-41.
4. Alkhouri N., Tamimi R., Yerian L. The inflamed liver and atherosclerosis: a Link between histologic severity of nonalcoholic fatty liver disease and increased cardiovascular risk. Digestive Diseases and Sciences, 2010; 55 (9): 2644-2650.
5. Dam-Larsen S., Becker U., Franzmann M. B., Larsen K., P. Christoffersen, and F. Bendtsen. Final results of a long-term, clinical follow-up in fatty liver patients. Scandinavian Journal of Gastroenterology, 2009. vol. 44, no. 10, pp. 1236-1243.
6. Драпкина О. М., Зятенкова Е. В. Оценка ремоделирования сердечно-сосудистой системы и толщины эпикардиального жира у пациентов с хронической сердечной недостаточностью и метаболическим синдромом. Терапевтический архив, 2016; 88 (2):64-70.
7. Drapkina O. M. Zyatenkova E. V. Evaluation of cardiovascular remodeling and epicardial fat thickness in patients with chronic heart failure and metabolic syndrome. Terapevticheskij arkhiv, 2016; 88 (2):64-70.
8. Alkhouri N., Tamimi T. A. R., Yerian L. et al. The inflamed liver and atherosclerosis: a Link between histologic severity of nonalcoholic fatty liver disease and increased cardiovascular risk. Digestive Diseases and Sciences, 2010; 55 (9):2644-2650.
9. Targher G, Bertolini L, Padovani R. et al. Relation of nonalcoholic hepatic steatosis to early carotid atherosclerosis in healthy men: role of visceral fat accumulation. Diabetes Care 2004; 27 (10):2498-2500.
10. Ebenezer T. Oni, Arthur S. Agatstonb, Michael J. Blaha. et al. A systematic review: Burden and severity of subclinical cardiovascular disease among those with nonalcoholic fatty liver; Should we care? Atherosclerosis, 2013; 230: 258-267.
11. Sookoian S, Pirola CJ. Non-alcoholic fatty liver disease is strongly associated with carotid atherosclerosis: a systematic review. J Hepatol 2008; 49:600-607.
12. Kim D., Choi S. Y., Park E. H. et al. Nonalcoholic fatty liver disease is associated with coronary artery calcification. Hepatology, 2012; 56 (2):605-613.
13. Santos R. D, Nasir K, Conceicao R. D. et al. Hepatic steatosis is associated with a greater prevalence of coronary artery calcification in asymptomatic men. Atherosclerosis 2007;194 (2):517-9.
14. Chen C. H, Nien C. K, Yang C. C. et al. Association between nonalcoholic fatty liver disease and coronary artery calcification. Dig Dis Sci 2010;55 (6):1752-60.
15. Assy N, Djibre A, Farah R. et al. Presence of coronary plaques in patients with nonalcoholic fatty liver disease. Radiology 2010;254 (2):393-400.
16. Villanova N, Moscatiello S, Ramilli S. et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology 2005;42 (2):473-80.
17. Senturk O, Kocaman O, Hulagu S. et al. Endothelial dysfunction in Turkish patients with non-alcoholic fatty liver disease. Intern Med J 2008;38 (3):183-9.
18. Colak Y, Senates E, Yesil A. et al. Assessment of endothelial function in patients with nonalcoholic fatty liver disease. Endocrine 2013;43 (1):100-7.
19. Mohammadi A, Sedani HH, Ghasemi-Rad M. Evaluation of carotid intimamedia thickness and flow-mediated dilatation in middle-aged patients with nonalcoholic fatty liver disease. Vasc Health Risk Manag 2011;7:661-5.
20. Dogan S, Celikbilek M, Yilmaz YK. et al. Association between liver fibrosis and coronary heart disease risk in patients with nonalcoholic fatty liver disease. European Journal of Gastroenterology & Hepatology 2015, 27:298-304.
21. Goland S., Shimoni S., T. Zornitzki et al. Cardiac abnormalities as a new manifestation of nonalcoholic fatty liver disease: echocardiographic and tissue Doppler imaging assessment. Journal of Clinical Gastroenterology, 2006; 40 (10):949-955.
22. Bonapace S, Valbusa F, Bertolini L, Pichiri I. Nonalcoholic Fatty liver disease is associated with aortic valve sclerosis in patients with type 2 diabetes mellitus. PLoS One. 2014; 5;9 (2):e88 371.
23. Angulo P., Hui J., Marchesini G. et al. The NAFLD Fibrosis Score: A Noninvasive System That Identifies Liver Fibrosis in Patients with NAFLD. Hepatology, 2007; 4 (45):846-854.
24. Kim D, Kim WR, Kim HJ, Therneau TM. Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States. Hepatology. 2013; 57 (4):1357-65.
25. Sesti G, Sciacqua A., Vanessa T., Perticone M. et al. Association between Noninvasive Fibrosis Markers and Cardio-Vascular Organ Damage among Adults with Hepatic Steatosis. PLoS One. 2014 11; 9 (8):e104 941.
Review
For citations:
Drapkina O.M., Zyatenkova E.V. PREDICTION OF LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEART FAILURE AND METABOLIC SYNDROME. Experimental and Clinical Gastroenterology. 2016;(6):37-41. (In Russ.)
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