Coronary flow reserve is impaired in patients with nonalcoholic fatty liver disease: association with liver fibrosis.
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular disease. Coronary flow reserve (CFR) is widely used to examine the integrity of coronary microvascular circulation. We evaluated the prevalence of impaired CFR in patients with biopsy-proven NAFLD. We also investigated the independent clinical, biochemical, and liver histology predictors of CFR in the setting of NAFLD.


METHODS
Fifty-nine consecutive patients with NAFLD and 77 age- and gender-matched controls were evaluated. CFR recordings were performed by transthoracic Doppler harmonic echocardiography. CFR>or=2.0 was considered normal.


RESULTS
CFR was significantly lower in patients with NAFLD than in controls (2.11+/-0.45 vs. 2.52+/-0.62, P<0.001). An impaired CFR (i.e. <2) was found in 25 NAFLD patients (42.4%) whereas all controls had normal CFR values (P<0.001). A stepwise linear regression analysis in NAFLD patients identified liver fibrosis scores as the only independent predictor of CFR values (beta=-0.60; t=-2.44, P=0.021).


CONCLUSIONS
Our findings indicate that in patients with biopsy-proven NAFLD: (a) an abnormal CFR is found in approximately 42.4% of cases, and (b) liver fibrosis scores are an independent predictor of depressed CFR.
Yilmaz
Yusuf
Y
Department of Gastroenterology, Marmara University School of Medicine, Tophanelioglu Cad. No: 13/15 Altunizade, 34662 Istanbul, Turkey. yusufyilmaz@uludag.edu.tr
Kurt
Ramazan
R
Yonal
Oya
O
Polat
Nihat
N
Celikel
Cigdem Ataizi
CA
Gurdal
Ahmet
A
Oflaz
Huseyin
H
Ozdogan
Osman
O
Imeryuz
Nese
N
Kalayci
Cem
C
Avsar
Erol
E
D000328:Adult; D001783:Blood Flow Velocity; D003326:Coronary Circulation; D005234:Fatty Liver / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged