ORIGINAL ARTICLE   

Minerva Cardioangiologica 2020 February;68(1):42-6

DOI: 10.23736/S0026-4725.19.05087-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

The association between non-alcoholic fatty liver disease and valvular heart disease

Amir MARI ^{1, 2} ✉, Tawfik KHOURY ^{1, 2, 3}, Helal SAID AHMAD ^{1, 2, 3}, Fadi ABU BAKER ^{4, 5}, Anas KADAH ^{2, 3}, Wisam SBEIT ^{2, 3}, Rinaldo PELLICANO ⁶, Mahmud MAHAMID ^{1, 2}

¹ Unit of Gastroenterology and Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel; ² Faculty of Medicine, Bar-Ilan University, Safed, Israel; ³ Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel; ⁴ Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel; ⁵ Technion Faculty of Medicine, Haifa, Israel; ⁶ Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy

BACKGROUND: Non-alcoholic fatty liver (NAFLD) disease has become the commonest cause of end-stage liver disease. Patients with NAFLD have an increased risk of associated extrahepatic conditions, including structural and functional cardiovascular disease. Still, it is unknown if there is an association between NAFLD and valvular heart disease (VHD). The aim of this paper was to determine the association between NAFLD and VHD.
METHODS: We performed a single center retrospective study in EMMS Nazareth Hospital from April 2010 to April 2018. All patients who were diagnosed with NAFLD and who had an echocardiography performed within one year were included. Subjects age and sex-matched, who had echocardiography performed in the same period were included in the control group.
RESULTS: The mean age of the NAFLD group was 41.5±11.7 vs. 42.8±10.8 years of the control group (P=0.2). The prevalence of aortic stenosis, aortic insufficiency, mitral stenosis and mitral insufficiency were significantly higher in NAFLD patients compared to the control group (1.2% vs. 0.22%, 1.32% vs. 0.32%, 0.66% vs. 0.27%, and 1.87% vs. 0.41%, respectively; P<0.001). In the multivariate logistic regression analysis, NAFLD was found to be independent risk factor for VHD (OR 2.39, 95% CI 2.17-2.78, P<0.001).
CONCLUSIONS: VHD was significantly seen more frequently in NAFLD patients compared to controls. Prospective studies are needed to validate our findings and to elucidate the pathogenesis of VHD in patients with NAFLD.

KEY WORDS: Fatty liver; Heart; Aortic valve stenosis; Aortic valve insufficiency