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

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 ; TE (Fibroscan®-CAP). Clarification of present study may help to provide a new non-invasive tool for assessment of NAFLD in this specific population of patients and may be of clinical importance in planning preventive strategies in high risk patients. Seventy-five 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. Of the 75 patients, 45(60%) had CAP>238 dBm-1 and by definition NAFLD. Among the patients with NAFLD 24 patients (53.3%) had in addition liver stiffness>7 kPa. Analyzing the influence of degree of liver steatosis (expressed by CAP values) on the degree of coronary heart disease (defined by single or multiple vessels involved) we have found that patients with multiple vessels involved had higher CAP values (p=0.002). Furthermore, we have 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. The main finding of our study is that TE provides the opportunity of non-invasive screening for NAFLD in CHD patients, because it is a quick, simple, reliable and repeatable method and more cost-effective than liver biopsy.

nonalcoholic fatty liver disease (NAFLD); transiet elastography; coronary heart disease

Focus Cardiology.