Table 2.
Univariate Analyses of the Longitudinal Association of Non‐Alcoholic Fatty Liver Disease and Echocardiographic Markers of Cardiac Geometry and Remodeling and Left Ventricular Function
| Prevalent Y30 Cardiac Dimensions | Incident Y25 to Y30* Cardiac Dimensions | |||||
|---|---|---|---|---|---|---|
| No NAFLD (n=1668) | NAFLD (n=159) | P Value | No NAFLD (n=1668) | NAFLD (n=159) | P Value | |
| Longitudinal association of NAFLD with cardiac geometry and remodeling | ||||||
| Cardiac dimensions | ||||||
| LV mass, g | 166.7±52.7 | 200.7±67.4 | <0.0001† | 3.4±41.3 | 4.3±53.2 | 0.80 |
| LV mass index to height2.7, g/m2.7 ‡ | 40.1±11.8 | 45.9±13.2 | <0.0001† | 1.0±10.0 | 1.2±12.2 | 0.83 |
| LV mass index to BSA, g/m2 | 79.0±20.0 | 87.3±24.0 | <0.0001† | −2.3±19.8 | −0.17±21.9 | 0.23 |
| LV hypertrophy, n (%) | 405 (24.3) | 74 (46.5) | <0.0001† | 188 (11.3) | 28 (17.6) | <0.0001† |
| LV internal diameter, systole, cm§ | 1.9±0.25 | 2.0±0.30 | 0.004† | 0.10±0.26 | 0.12±0.28 | 0.27 |
| LV internal diameter, diastole, cm§ | 2.9±0.27 | 3.0±0.29 | 0.0002† | −0.09±0.24 | −0.08±0.25 | 0.76 |
| LV posterior wall diameter, cm | 0.94±0.16 | 1.02±0.18 | <0.0001† | 0.06±0.18 | 0.06±0.21 | 0.79 |
| Interventricular septum, diastole, cm | 0.93±0.19 | 1.0±0.20 | <0.0001† | 0.04±0.20 | 0.03±0.21 | 0.88 |
| LV relative wall thickness | 0.38±0.08 | 0.40±0.08 | 0.03† | 0.04±0.09 | 0.03±0.09 | 0.65 |
| Concentric LV geometry | 405 (24.3) | 52 (32.7) | 0.02† | 297 (17.8) | 34 (21.4) | 0.06 |
| LV chamber characteristics | ||||||
| Normal geometry, n (%) | 1029 (61.7) | 64 (40.3) | Reference† | 1329 (46.0) | 120 (75.4) | Reference† |
| Any abnormal geometry, n (%) | 638 (38.2) | 95 (59.7) | <0.0001† | 340 (20.4) | 39 (24.5) | <0.0001† , ∥ |
| Concentric remodeling | 233 (14.0) | 21 (13.2) | ||||
| Concentric hypertrophy | 172 (10.3) | 31 (19.5) | ||||
| Eccentric hypertrophy | 233 (14.0) | 43 (27.0) | ||||
| Left atrial diameter, cm | 3.9±0.49 | 4.2±0.49 | <0.0001† | 0.25±0.41 | 0.29±0.48 | 0.24 |
| Left atrial volume, mL | 50.7±16.2 | 56.2±18.5 | <0.0001† | 1.1±9.4 | 1.6±10.5 | 0.54 |
| Left atrial volume index, mL/m§ | 29.9±9.2 | 32.6±10.2 | 0.0008† | 1.7±15.9 | 2.6±18.0 | 0.51 |
| Longitudinal association of NAFLD with LV function | ||||||
| LV systolic function | ||||||
| LV ejection fraction, % | 60.2±5.4 | 58.9±6.5 | 0.005† | −1.5±7.5 | −3.0±7.9 | 0.02† |
| Abnormal ejection fraction <50% | 64 (3.8) | 11 (6.9) | 0.04† | 46 (2.8) | 4 (2.5) | 0.91 |
| Longitudinal strain, % | −15.3±2.8 | −13.9±2.7 | <0.0001† | 0.001±3.0 | −0.04±3.2 | 0.88 |
| Circumferential strain, % | −14.7±3.7 | −13.3±3.4 | <0.0001† | 0.74±4.1 | 1.4±4.1 | 0.13 |
| LV diastolic function | ||||||
| E/A ratio | 1.2±0.34 | 1.1±0.33 | <0.0001† | −0.13±0.35 | −0.10±0.31 | 0.47 |
| Isovolumic relaxation time, ms | 67.8±15.6 | 67.2±16.3 | 0.68 | −5.5±17.6 | −7.3±17.3 | 0.26 |
| E deceleration time, ms | 176.1±38.9 | 180.4±38.4 | 0.19 | 41.9±59.6 | 36.6±51.5 | 0.29 |
| Lateral tissue Doppler e′ velocity, cm/s | 12.0±2.8 | 10.8±2.6 | <0.0001† | −0.51±2.7 | −0.55±2.6 | 0.89 |
| E/e′ ratio | 7.2±2.3 | 7.9±2.6 | 0.0004† | 0.25±2.2 | 0.25±2.6 | 1.0 |
| Hemodynamic variables | ||||||
| Cardiac output, L/min | 4.7±1.2 | 5.5±1.5 | <0.0001† | −0.91±1.4 | −1.1±1.7 | 0.25 |
| Cardiac index, L/min per m2 | 2.4±0.54 | 2.5±0.59 | 0.01† | −0.47±0.71 | −0.47±0.74 | 1.0 |
| Heart rate, bpm | 64.6±10.3 | 68.3±10.8 | <0.0001† | −0.35±9.5 | −0.08±9.5 | 0.74 |
Non‐alcoholic fatty liver disease=liver attenuation ≤40 HU after exclusions for secondary causes of liver fat. Left ventricular hypertrophy was defined as left ventricular mass indexed to body surface area >115 g/m2 (men) or >95 g/m2 (women). Concentric left ventricular geometry was defined as relative wall thickness >0.42. Concentric remodeling was defined as relative wall thickness >0.42 and left ventricular hypertrophy. Concentric hypertrophy was defined as relative wall thickness >0.42 and left ventricular hypertrophy. Eccentric hypertrophy was defined as relative wall thickness ≤0.42 and left ventricular hypertrophy.24 Results are expressed as mean±SD for continuous variable and n (%) for categorical variables, t test for continuous variables, Chi‐square for categorical variables. LV indicates left ventricular; NAFLD, non‐alcoholic fatty liver disease.
Incident defined as Y25 measurement−Y30 measurement.
Statistically significant.
In secondary analysis with left ventricular mass indexed to height, results were similar.
Indexed to height.
Result from multinomial model with normal as referent,24 n=700 participants were missing measurements for calculation of left ventricular geometry at Y30.