title: Non alcoholic steatohepatitis is associated with subclinical impairment in left ventricular function measured by speckle tracking echocardiography.
abstract: OBJECTIVE
  Nonalcoholic steatohepatitis (NASH) is a part of histological spectrum of nonalcoholic fatty liver disease (NAFLD). Higher incidence of cardiovascular mortality has been reported in studies including patients with NAFLD. Impaired myocardial function can be detected by a novel echocardiographic method called speckle tracking echocardiography (STE) when conventional methods were normal.
  
  
  METHODS
  Twenty-eight biopsy-proven NASH patients (mean age 41.6 ± 9.8, 16 male) without hypertension and diabetes mellitus were included in study. All patients underwent transthoracic echocardiography. Offline analyses of images was performed and strain (S), strain rate (SR) parameters compared between NASH patients and controls. Statistical analysis were done by independent samples t test between groups and a multiple linear regression model was used to identify the statistical significance of relationships between selected variables.
  
  
  RESULTS
  R(SR-S) values were similar but R(S), R(SR-E), R(SR-E/A) values were significantly lower and R(SR-A) was higher in the NASH patients. There were no significant differences in CS, C(SR-S), C(SR-E), C(SR-A) and C(SR-E/A) values among the two groups. The most impressive results were obtained from longitudinal strain and strain rate parameters. LS, L(SR-S), L(SR-E), L(SR-A), values were significantly lower in NASH group when compared with healty controls. Linear regression analysis showed that RS and LS was not associated with diastolic blood pressure, total cholesterol and LDL cholesterol.
  
  
  CONCLUSIONS
  The LV longitudinal and radial systolic functions may be deteriorated in patients with NASH even in the absence of apparent decrease in the LV ejection fraction. STE may be useful in detecting preclinical LV impairment in patients with NASH.
authors.affiliation: Department of Cardiology, Kayseri Education and Research Hospital; Kayseri-Turkey. aobaktir@gmail.com.
authors.forename: Ahmet Oğuz
authors.initials: AO
authors.lastname: Baktır
authors.forename: Bahadır
authors.initials: B
authors.lastname: Şarlı
authors.forename: R Emre
authors.initials: RE
authors.lastname: Altekin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karaman
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Arınç
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Sağlam
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Doğan
authors.forename: Abdulsamet
authors.initials: A
authors.lastname: Erden
authors.forename: Hatice
authors.initials: H
authors.lastname: Karaman
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*