Cirrhotic Cardiomyopathy and Cardiac Dysfunction in Patients with Metabolic Dysfunction Associated Steatotic Liver Disease
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 150
- 试验地点
- 1
- 主要终点
- To determine the prevalence of cardiac dysfunction in patients with non-alcoholic fatty liver disease/ metabolic dysfunction associated steatotic liver disease
研究概览
简要总结
Cirrhotic cardiomyopathy is seen as a blunted contractile responsiveness to stress, and/or altered diastolic relaxation with electrophysiological abnormalities, in absence of known cardiac disease. Left ventricular diastolic dysfunction (LVDD) is associated with risk of hepatorenal syndrome (HRS) , septic shock. , heart failure in the perioperative period following liver transplantation, and after trans-jugular intrahepatic portosystemic shunt (TIPS) insertion . The echocardiographic E/e' ratio is a predictor of survival in LVDD, with multiple studies, including prospective data from our Centre. The inability of the heart to cope with stress or sepsis induced circulatory failure is a key concept of the increased mortality risk due to LVDD. In view of the metabolic syndrome and diabetes epidemic and an increasing number of patients being diagnosed with non-alcoholic fatty liver disease, there is increased risk of developing cardiac dysfunction due to multiple comorbidities including coronary artery disease, hypertensive heart disease, cirrhotic cardiomyopathy, which are contributors to overall cardiovascular risk of mortality.
详细描述
Nonalcoholic fatty liver disease (NAFLD) and heart failure (HF) are obesity-related conditions with high cardiovascular mortality. Many new studies have linked NAFLD to changes in myocardial energy metabolism, and to echocardiographic measurements of cardiac dysfunction especially heart failure with preserved ejection fraction. Cardiac dysfunction in NAFLD is related to the release of inflammatory cytokines among those with steatohepatitis (NASH). However composite models looking at coronary artery disease, systolic and diastolic heart failure and outcomes in patients with NAFLD are limited, and the few preliminary analyses of this relationship using histologically-defined NASH or lean NAFLD remain unclear.
In this project the investigators will screen patients with a diagnosis of 'non-alcoholic fatty liver disease' for presence of coronary artery disease, arrhythmias, cirrhotic cardiomyopathy and develop a model for cardiac dysfunction in such patients.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age range of 18-65 years
- •metabolic dysfunction associated steatotic liver disease as diagnosed either by histology or clinical, laboratory, non invasive tests, USG findings and vibration controlled transient elastography (VCTE).
排除标准
- •Age >65 years
- •Chronic renal disease
- •Pregnancy and peripartum cardiomyopathy
- •Hypertension
- •Valvular heart disease
- •Sick sinus syndrome/ Pacemaker
- •Cardiac rhythm disorder
- •Hypothyroidism
- •Hyperthyroidism
- •Portal vein thrombosis
- •Transjugular intrahepatic porto systemic shunt (TIPS) insertion
- •Hepatocellular carcinoma
- •Anemia Hb < 8gm/dl in females, and < 9 gm/dl in males at the time of assessment
结局指标
主要结局
To determine the prevalence of cardiac dysfunction in patients with non-alcoholic fatty liver disease/ metabolic dysfunction associated steatotic liver disease
时间窗: At Enrolment
Prevalence of CCM in the MASLD cohort
次要结局
- Presence of myocardial abnormalities in CCM dysfunction(At Enrolment)
- Presence of perfusion abnormalities in CCM dysfunction(At Enrolment)
- All cause mortality in metabolic dysfunction associated steatotic liver disease(12 months after enrolment)
- To determine the severity of cardiac dysfunction in patients with metabolic dysfunction associated steatotic liver disease(At Enrolment)
- Cardiac event related mortality in MASLD(12 months after enrolment)
研究者
Madhumita Premkumar
Associate Professor
Post Graduate Institute of Medical Education and Research, Chandigarh