Abstract 15608: Impaired Myocardial Perfusion Reserve in Patients with Fatty Liver Disease Assessed by Quantitative Myocardial Perfusion MRI
Background: Nonalcoholic fatty liver disease has been shown to be a risk factor of coronary artery disease (CAD) even in patients without metabolic syndrome. However, the relationship between fatty liver and altered myocardial perfusion reserve (MPR) has not been investigated in subjects without CAD. The purpose of this study was to determine whether the presence of fatty liver is associated with subclinical alteration of MPR in subjects without CAD.
Methods: A retrospective analysis was performed on 65 asymptomatic subjects without CAD who underwent both plain abdominal CT and cardiac MRI, and who also demonstrated normal LV wall motion, no regional myocardial ischemia and no myocardial scar on MRI. Myocardial perfusion MRI was acquired with a dual bolus method for saturation correction. Myocardial blood flow (MBF) was quantified in 16 myocardial segments by using a Patlak plot method. MPR was calculated as stress MBF divided by rest MBF.
Results: Fatty liver was observed in 18 (28%) of 65 subjects. No significant difference was found in the rest MBF between subjects with fatty liver and those without fatty liver (1.20 ± 0.74 vs. 1.10 ± 0.66 mL/min/g, P = 0.59). However, the mean MPR was significantly lower in fatty liver subjects than in non-fatty liver subjects (2.27 ± 0.73 vs. 3.26 ± 1.37, P < 0.005). Subjects with fatty liver had a higher prevalence of MPR <2.5 (78% vs. 38%, P<0.005) and higher triglyceride levels (206 ± 61 vs. 92 ±37 mg/dl, P<0.001). No significant difference was found in age, gender, systolic blood pressure, fasting glucose level and low-density lipoprotein level between the two groups. Multi-variable analysis revealed the presence of fatty liver is a significant predictor of reduced MPR with an odds ratio of 5.3 (P<0.01). Although a high triglyceride level showed significant univariable association with reduced MPR, this relation was no longer significant with multi-variable analysis.
Conclusion: Nonalcoholic fatty liver disease is an important risk factor for predicting impaired coronary microcirculation in subjects without CAD.
- © 2010 by American Heart Association, Inc.