Could Fatty Liver Disease Increase Heart Failure Risk?

An association exists between fatty liver and subclinical heart failure in obese patients, according to a new study led by researchers from the Leiden University Medical Center in the Netherlands.

A team led by Leiden University’s Ralph Widya, MD, used proton magnetic resonance spectroscopy to non-invasively measure hepatic triglyceride content—a measure of fat in the liver—and cardiac MRI in order to evaluate left ventricular function in 714 male and female patients between the ages of 45 and 65. Overall, 45% of participants were classified as overweight, while 13% were determined to be obese.
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Widya and his colleagues found a connection between an increase in hepatic triglyceride content and a decrease in mean left ventricular diastolic function in the obese subgroup. The link between hepatic triglyceride content and left ventricular diastolic function existed independently of metabolic syndrome, according to the authors. This connection, they said, suggests that fatty liver itself could signify a risk of heart dysfunction beyond known cardiovascular risk factors.  

The researchers note that additional research is needed to study the impact of non-alcoholic fatty liver disease (NAFLD) on cardiovascular events, and to explore how this association differs between those of normal weight as well as overweight and obese patients.

An important factor in achieving weight reduction through dieting is motivation, says Widya, noting that primary care physicians can help provide patients with incentive to lose weight.

“The primary care practitioner could explain to patients that obesity puts them at risk for many diseases, [including] heart disease. Hopefully this triggers the patient to successfully perform the diet,” says Widya.

Most obese patients have fatty liver, which can easily be diagnosed by ultrasound, he says. As such, “the physician is supported by evidence brought by our study, which shows a relationship of liver fat and diastolic function, [regardless of] whether the patient has metabolic syndrome.”

While this relationship is “small,” it is important to recognize this link, “because it shows that the liver itself plays an important role, probably through inflammatory pathways,” says Widya, adding that “other studies have shown the beneficial effects of dietary interventions on the amount of fat in the liver. Hypothetically, this could have a beneficial effect on heart function in obese patients.”

—Mark McGraw

Reference:

Widya H, Lamb H, et al. Association between Hepatic Triglyceride Content and Left Ventricular Diastolic Function in a Population-based Cohort: The Netherlands Epidemiology of Obesity Study. Radiology. 2016.