title: Risk of cardiovascular, cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease.
abstract: Non-alcoholic fatty liver disease (NAFLD) has emerged as a public health problem of epidemic proportions worldwide. Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease (CHD), abnormalities of cardiac function and structure (e.g., left ventricular dysfunction and hypertrophy, and heart failure), valvular heart disease (e.g., aortic valve sclerosis) and arrhythmias (e.g., atrial fibrillation). Experimental evidence suggests that NAFLD itself, especially in its more severe forms, exacerbates systemic/hepatic insulin resistance, causes atherogenic dyslipidemia, and releases a variety of pro-inflammatory, pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications. Collectively, these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications. The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular, cardiac and arrhythmic complications, to briefly examine the putative biological mechanisms underlying this association, and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications.
authors.affiliation: Stefano Ballestri, Division of Internal Medicine, Pavullo Hospital, 41026 Pavullo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ballestri
authors.affiliation: Stefano Ballestri, Division of Internal Medicine, Pavullo Hospital, 41026 Pavullo, Italy.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Lonardo
authors.affiliation: Stefano Ballestri, Division of Internal Medicine, Pavullo Hospital, 41026 Pavullo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonapace
authors.affiliation: Stefano Ballestri, Division of Internal Medicine, Pavullo Hospital, 41026 Pavullo, Italy.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Byrne
authors.affiliation: Stefano Ballestri, Division of Internal Medicine, Pavullo Hospital, 41026 Pavullo, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Loria
authors.affiliation: Stefano Ballestri, Division of Internal Medicine, Pavullo Hospital, 41026 Pavullo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000175:diagnosis; D001281:Atrial Fibrillation / Q000473:pathology; D002318:Cardiovascular Diseases / Q000378:metabolism; D015897:Comorbidity; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis; D005234:Fatty Liver / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000737:chemistry; D008019:Life Style; D008099:Liver / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000473:pathology; D015995:Prevalence; D012107:Research Design; D012307:Risk Factors
chemical_list: D007328:Insulin
keywords: Arrhythmias; Arrhythmic complications; Cardiac complications; Cardiovascular disease; Coronary heart disease; Myocardial dysfunction; Non-alcoholic fatty liver disease; Valvular heart disease