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Semin Liver Dis 2022; 42(04): 465-474
DOI: 10.1055/s-0042-1757712
Review Article

NAFLD in Cardiovascular Diseases: A Contributor or Comorbidity?

Bing Chen
1   Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania
,
W.H. Wilson Tang
2   Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
,
Mario Rodriguez
3   John T. Milliken Department of Medicine, Division of Cardiovascular disease, Barnes-Jewish Hospital/Washington University in St. Louis School of Medicine, St. Louis, Missouri
,
Kathleen E. Corey
4   Liver Center, Gastroenterology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
,
Arun J. Sanyal
5   Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
,
Patrick S. Kamath
6   Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
,
Biykem Bozkurt
7   Winters Center for Heart Failure Research, Cardiovascular Research Institute (B.B.), Baylor College of Medicine, DeBakey VA Medical Center, Houston, Texas
,
Hafeez Ul Hassan Virk
8   Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio
,
Gregg S. Pressman
9   Division of Cardiovascular Diseases, Einstein Medical Center, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Jeffrey V. Lazarus
10   Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
11   Faculty of Medicine, University of Barcelona, Barcelona, Spain
,
Hashem B. El-Serag
12   Section of Gastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas
13   Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
,
Chayakrit Krittanawong
14   Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, New York
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Abstract

Nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases are both highly prevalent conditions around the world, and emerging data have shown an association between them. This review found several longitudinal and cross-sectional studies showing that NAFLD was associated with coronary artery disease, cardiac remodeling, aortic valve remodeling, mitral annulus valve calcifications, diabetic cardiomyopathy, diastolic cardiac dysfunction, arrhythmias, and stroke. Although the specific underlying mechanisms are not clear, many hypotheses have been suggested, including that metabolic syndrome might act as an upstream metabolic defect, leading to end-organ manifestations in both the heart and liver. Management of NAFLD includes weight loss through lifestyle interventions or bariatric surgery, and pharmacological interventions, often targeting comorbidities. Although there are no Food and Drug Administration–approved nonalcoholic steatohepatitis-specific therapies, several drug candidates have demonstrated effect in the improvement in fibrosis or nonalcoholic steatohepatitis resolution. Further studies are needed to assess the effect of those interventions on cardiovascular outcomes, the major cause of mortality in patients with NAFLD. In conclusion, a more comprehensive, multidisciplinary approach to diagnosis and management of patients with NAFLD and cardiovascular diseases is needed to optimize clinical outcomes.

Keywords

nonalcoholic fatty liver disease - nonalcoholic steatohepatitis - cardiovascular diseases - coronary artery disease - heart failure


Publication History

Article published online:
14 October 2022

© 2022. Thieme. All rights reserved.

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