NASH an independent predictor of cardiac dysfunction

Abstract

Background and Aim: Cardiac events are the most common cause of death in NAFLD. It is believed that there is an association between the inflammatory component of NAFLD and cardiac dysfunction. The gold standard for diagnosis of NAFLD is Liver biopsy. Based on histology, NAFLD is categorized into two, Non-alcoholic fatty liver (NAFL) and Non-alcoholic steatohepatitis (NASH). As biopsy is an invasive procedure, studies comparing cardiac dysfunction in NAFL and NASH are few. The aim of the our study is to compare cardiac dysfunction in patients with NAFL and NASH. Methods: This is a cross-sectional study in which all patients who were biopsy proven for NAFLD without stage 4 fibrosis were included . Cardiac dysfunction in these patients was assessed by 2 D ECHO. Results: Out of the 92 patients, 52 were males and 40 were females ( 53.5% vs 46.5 %) . Among these patients 48 had NAFL, whereas 44 had NASH. Majority of the patients with NASH had cardiac dysfunction (32/44) while only a few patients with NAFL(4/48) had cardiac dysfunction( p value = 0.002) . Among the variables that can cause diastolic dysfunction i.e. coronary artery disease, dyslipidaemia, diabetes mellitus and hypertension, only diabetes mellitus had an independent association . By Binary logistic Regression it was seen that NASH was an independent risk factor for predicting cardiac dysfunction. Conclusions: The prevalence of cardiac dysfunction is more in NASH than NAFL in patients with NAFLD. NASH is an independent risk factor for cardiac dysfunction.