A Study of Left Ventricular Dysfunction in Normotensive Non Diabetic Patients with Non Alcoholic Fatty Liver Disease.

ABSTRACT

Non-Alcoholic Fatty Liver Disease is an emerging epidemic in the face of the new generation. It is considered the hepatic manifestation of the metabolic syndrome. With the increasing prevalence of obesity and metabolic syndrome, it has become a common sight in our outpatient department. We have investigated the echocardiographic parameters for systolic and diastolic dysfunction in the patients with NAFLD to evaluate its effects on the heart and hope our study could shine a light and provide us with a perspective into the various effects the metabolic syndrome has on our body. MATERIAL: We recruited 35 Normotensive, Non-Diabetic Non-Alcoholic Fatty Liver Disease Patients (NAFLD) of age ranging from 18 to 60 years of age diagnosed on the basis of ultrasound Abdomen and 35 Controls from both inpatient and outpatient department of Sawai Man Singh Medical College and Allied Hospitals from the month of August 2021 to October 2021 for the study. Every Patient underwent conventional transthoracic and Tissue Doppler Echocardiography along with their physical and metabolic parameters. All the patients of NAFLD were graded ultrasongraphically based on Hamaguchi et al criteria. OBSERVATION NAFLD patients had higher Body Mass Indices, Abdominal circumferences, Systolic Blood pressures, Total Cholesterol levels and Low-Density Lipoprotein levels in comparison to their normal counterparts. On the Echocardiographic front, the patient underwent transthoracic 2D ECHO and we observed an increased interventricular septum thickness (0.99 ± 0.04 vs 0.78 ± 0.05, p <0.0001), posterior wall thickness (0.96±0.05 vs 0.75±0.04 p < 0.0001) and left ventricular Mass (173±22.6 vs 116±8.24 p < 0.0001). On Tissue Doppler Imaging (TDI) we observed a decreased E/A ratio (1.25 ± 0.17 vs 1.44 ± 0.22 p < 0.0001) which was suggestive of an increased Left ventricular Dysfunction. On correlational analysis, we had made an observation that there was a positive correlation of the grading of fatty liver with that of interventricular septum thickness (r= 0.5305 p = 0.001), posterior wall thickness (r = 0.4362 p= 0.088) and left ventricular mass (r = 0.6292, p = 0.0001) with the grade of fatty liver. CONCLUSION: From our study, it was imperative that NAFLD even in the absence of Hypertension or Diabetes has a role in the impairment of Systolic and Diastolic function of the left ventricle and its role in cardiovascular morbidity and mortality cannot be ignored.