Cardiovascular and hepatic disease associations by magnetic resonance imaging: A retrospective cohort study
BackgroundHepatic disease is linked to cardiovascular events but the independent association between hepatic and cardiovascular disease remains unclear, given shared risk factors. MethodsThis was a retrospective study of consecutive patients with a clinical cardiac MRI (CMR) and a serological marker...
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Published in | Frontiers in cardiovascular medicine Vol. 9; p. 1009474 |
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Abstract | BackgroundHepatic disease is linked to cardiovascular events but the independent association between hepatic and cardiovascular disease remains unclear, given shared risk factors. MethodsThis was a retrospective study of consecutive patients with a clinical cardiac MRI (CMR) and a serological marker of hepatic fibrosis, the FIB-4 score, within one year of clinical imaging. We assessed the relations between FIB-4 scores grouped based on prior literature: low (< 1.3), moderate (1.3-3.25), and high (>3.25), and abnormalities detected by comprehensive CMR grouped into 4 domains: cardiac structure (end diastolic volumes, atrial dimensions, wall thickness); cardiac function (ejection fractions, wall motion abnormalities, cardiac output); vascular structure (ascending aortic and pulmonary arterial sizes); and cardiac composition (late gadolinium enhancement, T1 and T2 times). We used Poisson regression to examine the association between the conventionally defined FIB-4 category (low <1.3, moderate 1.3-3.25, and high >3.25) and any CMR abnormality while adjusting for demographics and traditional cardiovascular risk factors. ResultsOf the 1668 patients studied (mean age: 55.971 ± 7.28, 901 [54%] male), 85.9% had ≥1 cardiac abnormality with increasing prevalence seen within the low (82.0%) to moderate (88.8%) to high (92.3%) FIB-4 categories. Multivariable analyses demonstrated the presence of any cardiac abnormality was significantly associated with having a high-range FIB-4 (prevalence ratio 1.07, 95% CI: 1.01-1.13); notably, the presence of functional cardiac abnormalities were associated with being in the high FIB-4 range (1.41, 1.21-1.65) and any vascular abnormalities with being in the moderate FIB-4 range (1.22, 1.01-1.47). ConclusionsElevated FIB-4 was associated with cardiac functional and vascular abnormalities even after adjustment for shared risk factors in a cohort of patients with clinically referred CMR. These CMR findings indicate that cardiovascular abnormalities exist in the presence of subclinical hepatic fibrosis, irrespective of shared risk factors, underscoring the need for further studies of the heart-liver axis. |
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AbstractList | BackgroundHepatic disease is linked to cardiovascular events but the independent association between hepatic and cardiovascular disease remains unclear, given shared risk factors.MethodsThis was a retrospective study of consecutive patients with a clinical cardiac MRI (CMR) and a serological marker of hepatic fibrosis, the FIB-4 score, within one year of clinical imaging. We assessed the relations between FIB-4 scores grouped based on prior literature: low (< 1.3), moderate (1.3–3.25), and high (>3.25), and abnormalities detected by comprehensive CMR grouped into 4 domains: cardiac structure (end diastolic volumes, atrial dimensions, wall thickness); cardiac function (ejection fractions, wall motion abnormalities, cardiac output); vascular structure (ascending aortic and pulmonary arterial sizes); and cardiac composition (late gadolinium enhancement, T1 and T2 times). We used Poisson regression to examine the association between the conventionally defined FIB-4 category (low <1.3, moderate 1.3–3.25, and high >3.25) and any CMR abnormality while adjusting for demographics and traditional cardiovascular risk factors.ResultsOf the 1668 patients studied (mean age: 55.971 ± 7.28, 901 [54%] male), 85.9% had ≥1 cardiac abnormality with increasing prevalence seen within the low (82.0%) to moderate (88.8%) to high (92.3%) FIB-4 categories. Multivariable analyses demonstrated the presence of any cardiac abnormality was significantly associated with having a high-range FIB-4 (prevalence ratio 1.07, 95% CI: 1.01–1.13); notably, the presence of functional cardiac abnormalities were associated with being in the high FIB-4 range (1.41, 1.21–1.65) and any vascular abnormalities with being in the moderate FIB-4 range (1.22, 1.01–1.47).ConclusionsElevated FIB-4 was associated with cardiac functional and vascular abnormalities even after adjustment for shared risk factors in a cohort of patients with clinically referred CMR. These CMR findings indicate that cardiovascular abnormalities exist in the presence of subclinical hepatic fibrosis, irrespective of shared risk factors, underscoring the need for further studies of the heart-liver axis. |
Author | Berman, Daniel S. Ebinger, Joseph E. Hussain, Shehnaz K. Li, Debiao Cheng, Susan Driver, Matthew Kwan, Alan C. Navarrette, Jesse Sun, Nancy Botting, Patrick Noureddin, Mazen Ouyang, David |
AuthorAffiliation | 2 Department of Public Health Sciences, School of Medicine and Comprehensive Cancer Center, University of California , Davis, CA , United States 1 Departments of Cardiology, Internal Medicine, Biomedical Sciences, and Imaging, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars Sinai Medical Center , Los Angeles, CA , United States |
AuthorAffiliation_xml | – name: 2 Department of Public Health Sciences, School of Medicine and Comprehensive Cancer Center, University of California , Davis, CA , United States – name: 1 Departments of Cardiology, Internal Medicine, Biomedical Sciences, and Imaging, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars Sinai Medical Center , Los Angeles, CA , United States |
Author_xml | – sequence: 1 givenname: Alan C. surname: Kwan fullname: Kwan, Alan C. – sequence: 2 givenname: Nancy surname: Sun fullname: Sun, Nancy – sequence: 3 givenname: Matthew surname: Driver fullname: Driver, Matthew – sequence: 4 givenname: Patrick surname: Botting fullname: Botting, Patrick – sequence: 5 givenname: Jesse surname: Navarrette fullname: Navarrette, Jesse – sequence: 6 givenname: David surname: Ouyang fullname: Ouyang, David – sequence: 7 givenname: Shehnaz K. surname: Hussain fullname: Hussain, Shehnaz K. – sequence: 8 givenname: Mazen surname: Noureddin fullname: Noureddin, Mazen – sequence: 9 givenname: Debiao surname: Li fullname: Li, Debiao – sequence: 10 givenname: Joseph E. surname: Ebinger fullname: Ebinger, Joseph E. – sequence: 11 givenname: Daniel S. surname: Berman fullname: Berman, Daniel S. – sequence: 12 givenname: Susan surname: Cheng fullname: Cheng, Susan |
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Copyright | Copyright © 2022 Kwan, Sun, Driver, Botting, Navarrette, Ouyang, Hussain, Noureddin, Li, Ebinger, Berman and Cheng. 2022 Kwan, Sun, Driver, Botting, Navarrette, Ouyang, Hussain, Noureddin, Li, Ebinger, Berman and Cheng |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors have contributed equally to this work Edited by: David Niederseer, University Hospital Zürich, Switzerland Reviewed by: Maheswara Reddy Koppula, ECMC, United States; Jing Sun, Johns Hopkins University, United States This article was submitted to Cardiovascular Epidemiology and Prevention, a section of the journal Frontiers in Cardiovascular Medicine |
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Snippet | BackgroundHepatic disease is linked to cardiovascular events but the independent association between hepatic and cardiovascular disease remains unclear, given... |
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SubjectTerms | cardiac MRI Cardiovascular Medicine FIB-4 hepatic fibrosis liver disease NAFLD |
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Title | Cardiovascular and hepatic disease associations by magnetic resonance imaging: A retrospective cohort study |
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