Non-alcoholic fatty liver disease and the myocardial remodeling: the role of insulin resistance in the hepatocardial association development

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Aim.The aim of the study was to assess glucose metabolism, its perfusion in the cardiomyocytes and the detection of the myocardial dysfunction in patients with fatty liver disease and insulin resistance using the positron emission tomography with fl udeoxyglucose.Materials and methods.In our study patients with the non-alcoholic fatty liver disease and the insulin resistance were examined. All patients underwent the еchocardiography and the positron emission tomography scans for myocardial dysfunction assessment.Results and discussion.Echocardiography revealed various types of the left ventricular cardiac remodeling. The positron emission tomography showed a pronounced diffuse uneven distribution of the radiopharmaceutical. In addition, zones of hypometabolism and paradoxical accumulation of glucose were detected. It`s important to note that these indicated zones did not form sectors around a specifi c artery area, possibly refl ecting zones of fatty infi ltration or fi brotic changes in the myocardium. Thus, it was shown that in patients with the non-alcoholic fatty liver disease and insulin resistance the intensity and nature of glucose metabolism in cardiomyocytes were changed, indicating the presence of myocardial metabolic dysfunction.Conclusion.We believe that in systemic insulin resistance metabolic processes were disturbed not only in the liver cells, but also in the cardiomyocytes, the rate of glucose utilization and its transmembrane transfer into cardiomyocytes were changed. As a result of the metabolic dysfunction, the geometric parameters of the heart are changed and various types of the cardiac remodelling are formed.