Obésité

, Volume 12, Issue 4, pp 322–325 | Cite as

Revue de presse

Article
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Abstract

Objective

Preliminary data suggest that nonalcoholic fatty liver disease is associated with early heart failure (HF). However, whether nonalcoholic steatohepatitis (NASH) is directly associated with echocardiographic changes in cardiac structure or function remains unknown.

Methods

A retrospective cohort was identified of individuals (N=65) without known heart disease, undergoing elective bariatric surgery with perioperative liver biopsy, and available recent transthoracic echocardiography (TTE). TTE measures were evaluated by NASH status using correlation coefficients, ANOVA, and linear regression, accounting for cardiometabolic factors.

Results

Median age was 47 years; 22% (n=14) had NASH. NASH patients had increased median left atrial (LA) volume (28.6 mL/m2 vs. 24.8 mL/m2; P<0.0001) and left ventricular (LV) maßs (82.6 g/m2 vs. 78.6 g/m2; P<0.0001), indexed for height. NASH was inversely correlated with indices of diastolic function, including septal E’ (r=-0.90 [95% CI: -1.21 to -0.42]; P=0.020) and E:A (r=-0.31 [95% CI:-0.51 to -0.09]; P=0.037). In adjusted analyses, NASH remained aßsociated with increased LV maßs index (ß1=7.16 [SE: 4.95]; P=0.001) and LA volume index (ß1=0.19 [SE: 0.08]; P=0.001) and reduced lateral and septal E’ (ß1=-0.91, P=0.015; ß1=-0.89, P=0.047, respectively).

Conclusions

In this bariatric cohort, NASH was associated with changes in myocardial structure and in load-dependent indices of LV diastolic function, suggestive of subclinical HF.

Commentaires

Des données récentes suggèrent que l’inflammation systémique en lien avec les NASH, serait à l’origine de détérioration sub-clinique de la fonction cardiaque. Les auteurs ont ici tiré des données rétrospectives d’une cohorte de 65 patients ayant bénéficié d’une chirurgie bariatrique avec biopsie hépatique per-opératoire, et chez qui une échocardiographie transthoracique avait été réalisée en préopératoire. Des analyses de corrélation ont ensuite été effectuées. Il en ressort que les patients présentant une NASH histologiquement avérée, présentent davantage de trouble de relaxation myocardique et un volume atrial gauche majoré comparés aux patients sans NASH. La pathogenèse de ce phénomène reste néanmoins à éclaircir.

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Copyright information

© Lavoisier 2017

Authors and Affiliations

  1. 1.Service de nutrition, Centre spécialisé obésité (CSO)centre hospitalier d’ArrasArras cedexFrance
  2. 2.Unité Inserm U1172centre de recherche Jean-Pierre-AubertLille cedexFrance
  3. 3.Service de nutrition, CSOcentre hospitalier d’ArrasArras cedexFrance
  4. 4.Laboratoire PSITEC EA4072, université Lille-IIIdomaine du Pont-de-BoisVilleneuve-d’Ascq cedexFrance

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