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Wiener klinische Wochenschrift

, Volume 126, Issue 15–16, pp 474–479 | Cite as

Nonalcoholic fatty liver disease (NAFLD) proven by transient elastography in patients with coronary heart disease

  • Ivana Mikolasevic
  • Lidija Orlic
  • Sandra Milic
  • Vesna Lukenda
  • Sanjin Racki
  • Davor Stimac
  • Ervin Avdovic
  • Luka Zaputovic
original article

Summary

Background/aim

The relationship between nonalcoholic fatty liver disease (NAFLD) and coronary heart disease (CHD) is poorly understood. In the present study, we aimed to assess the frequency of NAFLD in CHD patients by using a new diagnostic tool: transient elastography (TE; Fibroscan®-CAP). Clarification of the present study may help to provide a new noninvasive tool for the assessment of NAFLD in this specific population of patients and may be of clinical importance in planning preventive strategies in high-risk patients.

Patients and methods

A total of 75 patients with proven CHD were enrolled. Liver stiffness was used to assess liver fibrosis, and controlled attenuation parameter (CAP) was used to detect and quantify liver steatosis by using Fibroscan® (Echosens, Paris, France). By CAP being implemented on TE, both liver steatosis and fibrosis can be evaluated simultaneously.

Results

Of the 75 patients, 45 (60 %) had CAP > 238 dBm−1 and, by definition, NAFLD. Among the patients with NAFLD, 24 (53.3 %) had, in addition, liver stiffness > 7 kPa. Analyzing the influence of the degree of liver steatosis (expressed by CAP values) on the degree of CHD (defined by single or multiple vessels involved), we found that patients with multiple vessels involved had higher CAP values (p = 0.002). Furthermore, we noticed that significantly more patients with multiple vessels involved had liver stiffness > 7 kPa (p < 0.0001) indicating the more severe form of NAFLD in those patients.

Conclusion

The main finding of our study is that TE provides the opportunity of noninvasive screening for NAFLD in CHD patients, as it is a quick, simple, reliable, and repeatable method and more cost-effective than liver biopsy.

Keywords

Nonalcoholic fatty liver disease (NAFLD) Transient elastography Coronary heart disease 

Nachweis einer nicht-alkoholischen Fettlebererkrankung (NAFLD) durch transiente Elastographie bei Patienten mit einer koronaren Herzerkrankung (CHD)

Zusammenfassung

Hintergrund/Ziel der Studie

Der Zusammenhang zwischen der NAFLD und der CHD ist unklar. In der vorliegenden Studie wollten wir die Häufigkeit einer NAFLD bei Patienten mit einer CHD unter Verwendung eines neuen diagnostischen Gerätes (TE – Transiente Elastographie; Fibroscan®- CAP) erheben. Die Ergebnisse unserer Studie könnten helfen, ein neues nicht-invasives Gerät zur Erfassung einer NAFLD bei dieser besonderen Patientenpopulation einzusetzen. Der klinische Nutzen könnte in der darauf basierenden Planung einer präventiven Strategie bei Hochrisikopatienten liegen.

Patienten und Methodik

Es wurden 75 Patienten mit nachgewiesener CHD in die Studie aufgenommen. Die Steifheit der Leber wurde zur Beurteilung einer möglichen Leberfibrose herangezogen. Der „Controlled Attenuation Parameter (CAP)“ wurde mit Hilfe eines Fibroscan® (Echosens, Paris, Frankreich) erhoben und zur Erkennung und Quantifizierung einer möglichen Lebersteatose eingesetzt. Durch die Einbeziehung der CAP in die TE kann sowohl die Steatose als auch die Fibrose der Leber beurteilt werden.

Ergebnisse

Von den 75 Patienten hatten 45 (= 60 %) ein CAP > 238 dBm−1 und damit per definitionem eine NAFLD. Von diesen Patienten mit NAFLD hatten 24 (= 53,3 %) eine Lebersteife > 7 kPa.Die Analyse eines möglichen Zusammenhangs zwischen dem Grad der Lebersteatose (ausgedrückt in CAP Werten) mit dem Schweregrad der CHD (definiert durch die Anzahl der befallenen Gefäße) ergab, dass Patienten mit einer Mehrgefäßerkrankung höhere CAP Werte (p = 0,002) aufwiesen. Auch eine Lebersteife > 7 kPa wurde bei diesen Patienten mit Mehrgefäßbefall signifikant häufiger erhoben.

Schlussfolgerung

Unsere Studie zeigt, dass die TE die Möglichkeit eines nicht-invasiven Screenings auf NAFLD bei CHD Patienten bietet. Die Methode ist ein rasches, einfaches, verlässliches und reproduzierbares Verfahren, – kosteneffizienter als eine Leberbiopsie.

Schlüsselwörter

Nicht-akoholische fettleber (NAFLD) Transiente Elastographie Koronare Herzerkrankung 

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Ivana Mikolasevic
    • 1
  • Lidija Orlic
    • 1
  • Sandra Milic
    • 2
  • Vesna Lukenda
    • 3
  • Sanjin Racki
    • 1
  • Davor Stimac
    • 2
  • Ervin Avdovic
    • 4
  • Luka Zaputovic
    • 4
  1. 1.Department of Nephrology and DialysisUniversity Hospital Center RijekaRijekaCroatia
  2. 2.Department of GastroenterologyUniversity Hospital RijekaRijekaCroatia
  3. 3.Department of Internal MedicineGeneral Hospital “Dr. Josip Bencevic”Slavonski BrodCroatia
  4. 4.Department of CardiologyUniversity Hospital RijekaRijekaCroatia

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