Association of Liver Fibrosis With Cardiovascular Diseases in the General Population: The Multi-Ethnic Study of Atherosclerosis (MESA)

Overview

Journal Circ Cardiovasc Imaging

Specialties Cardiology & Vascular Diseases
Radiology

Date 2018 Mar 11

PMID 29523555

Citations 39

Authors

Mohammad R Ostovaneh

Bharath Ambale-Venkatesh

Tomoki Fuji

Hooman Bakhshi

Ravi Shah

Venkatesh L Murthy

Russell P Tracy

Eliseo Guallar

Colin O Wu

David A Bluemke

Joao A C Lima

Affiliations

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Abstract

Background: The association of cardiovascular diseases (CVD) with liver fibrosis is poorly understood. We aim to assess the association of liver fibrosis by T1-mapping magnetic resonance imaging and CVD in MESA (Multi-Ethnic Study of Atherosclerosis).

Methods And Results: MESA enrolled 6814 participants free of clinical CVD at baseline (2000-2002). A subsample of participants underwent T1-mapping magnetic resonance imaging 10 years after the baseline (Y10 MESA exam, 2010-2012). Liver T1 maps were generated avoiding vessels and biliary ducts from which native T1 (n=2087) and extracellular volume fraction (ECV, n=1234) were determined. Higher ECV and native T1 were indicators of liver fibrosis. Linear regression analysis evaluated the cross-sectional relationship between liver native T1 and ECV at Y10 MESA exam with a history of CVD events (atrial fibrillation, heart failure, and coronary heart disease [CHD]). Of the 2087 participants (68.7±9.1 years; 46% females), 153 had prior CVD events (78 atrial fibrillation, 25 heart failure, and 78 CHD). History of CVD events was associated with 18.5 ms higher liver native T1 (<0.001) and 1.4% greater ECV (=0.06). Prior atrial fibrillation was related to higher liver native T1 (β=21.1; =0.001) and greater ECV (β=2.2; =0.02), whereas previous heart failure was associated with greater liver ECV (β=4.1; =0.02). There was also a relationship of prior CHD with liver native T1 (β=13; =0.05) and ECV (β=1.9; =0.05), which was attenuated by adjustment for coronary artery calcium score (β=7.1 and 1.6; =0.37 and 0.13, respectively).

Conclusions: Liver fibrosis by T1-mapping magnetic resonance imaging is associated with history of heart failure, atrial fibrillation, and CHD in a multiethnic cohort. The association of liver fibrosis and CHD is at least in part mediated by atherosclerosis.

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