Influence of non-alcoholic fatty liver disease on the cardiac hemodynamics indices and vascular disorders in patients with essential hypertension
Journal Title: Сучасна гастроентерологія - Year 2018, Vol 0, Issue 2
Abstract
Objective — to compare the structural and functional state of the heart, vessels and liver in patients with isolated EH and in conditions of its combination with NAFLD. Materials and methods. A total of 117 patients with NAFLD with EH stage II, 2 degree were examined in the LT Malaya National Institute of Therapy of the NAMS of Ukraine, from them 63 were men (53.86 %) and 54 women (46.14 %). The mean age was 54.4 ± 5.9 years. Thepatients were allocated into groups depending on the NAFLD presence and the NAFLD fibrosis score (NFS). Group 1 consisted of 74 patients with EH and NAFLD with NFS ≥ –1.455; group 2 included 43 patients with EH and NAFLD with NFS < –1.455; group 3 comprised 30 patients with isolated EH. The control group consisted of 20 practically healthy persons. Results. It has been established that structural and functional disorders of the heart and arteriesare specific for patients with NAFLD and EH. In contrast to the subjects with EH in combination with NAFLD without liver fibrosis and isolated EH, patients with NAFLD and liver fibrosis had significantly higher values of the thickness of intimamedia complex of the carotid arteries (CIM), LV myocardial mass ratio (LVMMR), left ventricular diastolic filling factor E/e. The preserved LV systolic function and prognostically unfavorable concentric (55.4 %) and eccentric (43.8 %) LV hypertrophy were specific for the patients with comorbidity of EH and NAFLD with liver fibrosis. The presence of significant direct correlation (rs = +0.34) between the level of NFS and LVMMR has been established, that proved the effects of the progression of liver damage on the LVHprogression in patients with NAFLD and EH; and significant direct correlation (rs = +0.28) between NFS and CIM.The significant reverse correlations were found between the NFS and E/e (rs = – 0.32), the NFS and endotheliumdependent vasodilation (EDVD) (rs = –0.31), which indicatedthe relationship between the presence and degree of hepatic fibrosis with the condition of the arteries in patients with comorbidity of NAFLD and EH. Conclusions. Patients with comorbidity of EH and NAFLD with liver fibrosis are characterized by the increasedvalues of carotid CIM, LVmyocardial mass ratio, the integral index of the LV diastolic filling E/e. The vascular wall alterations in these patients manifested in more intensive CIM thickening and decrease of the degree of endotheliumdependent vasodilation of brachial arteries in comparison with the patients with isolated EH.
Authors and Affiliations
K. О. Prosolenko, V. I. Molodan, A. S. Shalimova
Keywords
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