Keywords
metabolically associated fatty liver disease
cardiohemodynamics
dyslipidemia
How to Cite
Abstract
Abstract. Coronary heart disease (CHD) remains one of the leading causes of mortality and disability, especially in combination with metabolic-associated fatty disease (MAFLD). Over the past decades, it has become clear that MAFLD and nonalcoholic steatohepatitis have come to occupy the first place among all liver pathologies in most countries of the world, while the prevalence of other chronic liver diseases has not changed. The combination of CHD, atrial fibrillation (AF), and components of the metabolic syndrome significantly increases the risk of cardiovascular complications due to myocardial and endothelial dysfunction in systemic inflammatory syndrome.
The aim is to evaluate the effect of MAFLD on the structural and functional state of the heart in patients with stable CHD with AF.
Materials and methods. 80 patients with post-infarction cardiosclerosis and permanent AF of non-rheumatic origin were examined. According to the data of the clinical and diagnostic examination, the patients were divided according to the presence of MAFLD. In particular, 45 people without MAFLD and 35 people with MAFLD were selected. Among patients with MALD, steatosis was detected in 20 patients and non-alcoholic steatohepatitis in 15 people. The control group consisted of 20 practically healthy people. All patients underwent a general clinical examination, electrocardiography, echocardiography, blood lipid profile, and evaluation of the functional state of the liver.
The results. The analysis of the lipid spectrum indicators of the blood revealed the presence of dyslipidemia in all groups of patients, which is more pronounced in the case of MAFLD. The state of cardiac hemodynamics and heart geometry in the examined patients was characterized by the presence of signs of left ventricular hypertrophy, both according to metric and volumetric echocardiography data, with a decrease in its contractile capacity and a predominance of concentric hypertrophy, which was most pronounced against the background of MAFLD.
Conclusions. Patients with stable CHD with permanent AF, especially in the presence of MAFLD, are characterized by pronounced dyslipidemia, as evidenced by a high atherogenicity coefficient, as well as significant changes in cardiohemodynamics, which include a combination of dilatation of the LV cavity, a decrease in its contractile capacity, and the formation of concentric hypertrophy.
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