Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management
Abstract
:1. Introduction
- >5% macrovesicular steatosis;
- presence of inflammation;
- ballooning hepatocytes with predominantly centro-lobular distribution [9].
2. Non-Alcoholic Fatty Liver Disease and Arterial Hypertension
2.1. Systemic Inflammation
2.2. Insulin Resistance
2.3. Increased Vasoconstriction and Decreased Vasodilation
2.4. Arterial Stiffness
2.5. Increased Oxidative Stress
2.6. Gut Dysbiosis
2.7. Genetic and Epigenetic Modifications
3. Non-Alcoholic Fatty Liver Disease and Coronary Heart Disease
3.1. Insulin Resistance
3.2. Adipokines
3.3. Oxidative Stress
3.4. Lipid Peroxidation and Apoptosis
4. Non-Alcoholic Fatty Liver Disease and Cardiac Arrhythmias
4.1. Atrial Fibrillation
4.2. Ventricular Arrhythmias, Bundle Branch, and Atrioventricular Blocks
4.3. Mechanisms Behind Non-Alcoholic Fatty Liver Disease and Cardiac Arrhythmias
5. Non-Alcoholic Fatty Liver Disease and Altered Cardiac Structure
- abnormalities in cardiac metabolism;
- increased left ventricular mass;
- increased interventricular septum thickness;
- diastolic cardiac dysfunction;
- left atrium enlargement or impaired left atrium deformation;
- decreased right ventricular function;
- aortic and mitral valves calcification;
- congestive heart failure [111].
5.1. Abnormalities in Heart Metabolism
5.2. Increased Left Ventricular Mass and Interventricular Septum Thickness
5.3. Decreased Right Ventricular Function
5.4. Diastolic Cardiac Dysfunction and Risk of Congestive Heart Failure
6. Non-Alcoholic Fatty Liver Disease and Stroke
7. Non-Alcoholic Fatty Liver Disease and Thromboembolic Events
8. Therapeutic Management
8.1. Lifestyle Management and Dyslipidemia Treatment
8.2. Diabetes Mellitus Treatment
8.2.1. Pioglitazone
8.2.2. Metformin
8.2.3. Newer Antihyperglycemic Agents
8.3. Hypertension Treatment
8.3.1. Renin-Angiotensin-Aldosterone System Inhibitors
8.3.2. Probiotics and Prebiotics
8.4. Other Drugs That Might Have a Benefit in Non-Alcoholic Fatty Liver Disease
9. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Jichitu, A.; Bungau, S.; Stanescu, A.M.A.; Vesa, C.M.; Toma, M.M.; Bustea, C.; Iurciuc, S.; Rus, M.; Bacalbasa, N.; Diaconu, C.C. Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management. Diagnostics 2021, 11, 689. https://doi.org/10.3390/diagnostics11040689
Jichitu A, Bungau S, Stanescu AMA, Vesa CM, Toma MM, Bustea C, Iurciuc S, Rus M, Bacalbasa N, Diaconu CC. Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management. Diagnostics. 2021; 11(4):689. https://doi.org/10.3390/diagnostics11040689
Chicago/Turabian StyleJichitu, Alexandra, Simona Bungau, Ana Maria Alexandra Stanescu, Cosmin Mihai Vesa, Mirela Marioara Toma, Cristiana Bustea, Stela Iurciuc, Marius Rus, Nicolae Bacalbasa, and Camelia Cristina Diaconu. 2021. "Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management" Diagnostics 11, no. 4: 689. https://doi.org/10.3390/diagnostics11040689