HEPATOSTEATOSIS-ASSOCIATED CARDIOMYOPATHY: CORRELATIONAL ANALYSIS OF ECHOCARDIOGRAPHIC PARAMETERS

Abstract

We described the interaction of the liver and heart (liver-heart cross-talk) under the conditions of steatohepatitis and liver cirrhosis. The first stage of non-alcoholic fatty liver disease (NAFLD) is steatosis, the changes in the heart in these patients are still not sufficiently researched, which determines the relevance of our study. The aim is to analyze the correlations of echocardiographic parameters of the heart in patients with NAFLD. 331 patients were examined: 104 with CHD, unstable angina (CHD/UA); 75 with coronary heart disease, stable angina (CHD/SA); 50 with hemorrhagic vasculitis (HV); 44 with chronic rheumatic heart disease (CRHD) and 58 with acute rheumatic fever (ARF). They were divided into comparable groups: the main group with NAFLD and the control group with intact liver. We analyzed correlations of structural and functional echocardiographic parameters with other parameters.The results were processed statistically; the significance level is p<0.05. Increase in gepato-ateatosis index (GSI), which is a diagnostic criterion of NAFLD, combined with stretching of the left atrium (CHD/SA and HV both r=0.35) and aortic diameter (CHD/SA and HV both r=0.37) and myocardial hypertrophy (CRHD r=0.43), all p<0.05. The increase in the aspartataminotransferase to trombocytes (AST/Tr) ratio, which indicates transformation of NAFLD into steatohepatitis, was accompanied by LV stretching with a decrease in the ejection fraction. The leading mechanisms of structural and functional changes are the activation of inflammation (significant correlations with C-reactive protein, total fibrinogen, cellular elements), endogenous intoxication, especially increase in total bilirubin, lipid (correlation with total cholesterol, triglycerides, low and very low density lipoproteins) and glucose dysmetabolism. Сorrelational analysis of echocardiographic parameters of the heart confirms the presence of hepatosteatosisassociated cardiomyopathy in patients with hepatic steatosis. The leading mechanismsarein activation of inflammation and endogenous intoxication.