Evaluation of atrial and ventricular functions with 2-dimensional speckle tracking echocardiography in patients with non-alcoholic steatohepatitis: Mechanical dispersion as a new parameter

Aim: Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease with high cardiovascular morbidity and mortality. It is now considered as the "hepatic manifestation" of metabolic syndrome. Thus, it is important for the prognosis of the disease to detect the subclinical signs of cardiovascular involvement. In this study we aimed to evaluate the association between NAFLD and cardiac synchrony. Methods: 65 consecutive patients with the diagnosis of biopsy-proven non-alcoholic steatohepatitis patients and 39 age-and sex-matched controls were include in the study. All patients underwent an echocardiographic examination and the analiysis was done retrospectively. Conventional echocardiographic parameters were measured. Strain and mechanical dispersion parameters were evaluated by 2D speckle-tracking echocardiography (2D-STE) Results: Diabetes, hypertension, metabolic syndrome, insulin resistance and hyperlipidemia were found be more frequent among NASH patients. Left ventricular longitudinal strain, left ventricular circumferential strain and right ventricular strain were significantly lower in NASH patients. There was no significant difference regarding atrial global / phasic strain and mechanical dispersion between the groups. In the subgroup analysis, left atrial mechanical dispersion and right ventricle free wall strain were found to be independent predictors of liver fibrosis. Conclusion: Our study confirmed that, diastolic and ventricular strain parameters are impaired in NASH patients. However, atrial and ventricular mechanical dispersion values were similar between the groups. Studies with larger patients groups are needed to better interpret the results.