scholarly journals The association of hepatic steatosis and fibrosis with heart failure and mortality

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiyun Park ◽  
Gyuri Kim ◽  
Hasung Kim ◽  
Jungkuk Lee ◽  
You-Bin Lee ◽  
...  
Keyword(s):  
Heart Failure ◽  
General Population ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Patient Group ◽  
Cox Regression ◽  
Nonalcoholic Fatty Liver ◽  
Fatty Liver Index ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic disease and independently affects the development of cardiovascular (CV) disease. We investigated whether hepatic steatosis and/or fibrosis are associated with the development of incident heart failure (iHF), hospitalized HF (hHF), mortality, and CV death in both the general population and HF patients. Methods We analyzed 778,739 individuals without HF and 7445 patients with pre-existing HF aged 40 to 80 years who underwent a national health check-up from January 2009 to December 2012. The presence of hepatic steatosis and advanced hepatic fibrosis was determined using cutoff values for fatty liver index (FLI) and BARD score. We evaluated the association of FLI or BARD score with the development of iHF, hHF, mortality and CV death using multivariable-adjusted Cox regression models. Results A total of 28,524 (3.7%) individuals in the general population and 1422 (19.1%) pre-existing HF patients developed iHF and hHF respectively. In the multivariable-adjusted model, participants with an FLI ≥ 60 were at increased risk for iHF (hazard ratio [HR], 95% confidence interval [CI], 1.30, 1.24–1.36), hHF (HR 1.54, 95% CI 1.44–1.66), all-cause mortality (HR 1.62, 95% CI 1.54–1.70), and CV mortality (HR 1.41 95% CI 1.22–1.63) in the general population and hHF (HR 1.26, 95% CI 1.21–1.54) and all-cause mortality (HR 1.54 95% CI 1.24–1.92) in the HF patient group compared with an FLI < 20. Among participants with NAFLD, advanced liver fibrosis was associated with increased risk for iHF, hHF, and all-cause mortality in the general population and all-cause mortality and CV mortality in the HF patient group (all p < 0.05). Conclusion Hepatic steatosis and/or advanced fibrosis as assessed by FLI and BARD score was significantly associated with the risk of HF and mortality.

scholarly journals Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: A nationwide population-based study in Korea

2020 ◽  
Author(s):  
Jae-Hyung Roh ◽  
Jae-Hyeong Park ◽  
Hanbyul Lee ◽  
Yong-Hoon Yoon ◽  
Minsu Kim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Disease ◽  
Fatty Liver ◽  
Large Scale ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Liver Index ◽  
Fatty Liver Index ◽  
Increased Risk ◽  
New Onset

Abstract Background Heart failure (HF) is relatively common cardiovascular disease with high mortality and morbidity. Although it is associated with many cardiovascular risk factors, the association between nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease, and HF has not been evaluated in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver Index (FLI), a surrogate marker of NAFLD, to predict the development of HF in healthy individuals. Methods We analyzed the association between the FLI and new-onset HF with multivariate Cox proportional-hazards models in 308,578 healthy persons without comorbidities who underwent the National Health check-ups in the republic of Korea from 2009 to 2014. Results A total of 2,532 subjects (0.8%) were newly diagnosed with HF during the study period (a median of 5.4 years). We categorized our subjects into quartile groups according to FLI (Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The cumulative incidence of HF was significantly higher in the highest FLI group than in the lowest FLI group (Q1, 307 [0.4%] and Q4, 890 [1.2%]; P<0.001). Adjusted hazard ratio (HRs) indicated that the highest FLI group was independently associated with an increased risk for HF (HR between Q4 and Q1, 2.709; 95% confidence interval=2.380-3.085; P<0.001). FLI was significantly associated with an increased risk of new-onset HF regardless of their baseline characteristics.Conclusions Higher FLI was independently associated with increased risk of HF in a healthy Korean population.

Macrophage-modulating cytokines predict adverse outcome in heart failure

2010 ◽  
Vol 103 (02) ◽  
pp. 435-441 ◽  
Author(s):  
Philipp Hohensinner ◽  
Kathrin Rychli ◽  
Gerlinde Zorn ◽  
Martin Hülsmann ◽  
Rudolf Berger ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mononuclear Cells ◽  
Cox Regression ◽  
Adverse Outcome ◽  
Composite Endpoint ◽  
Advanced Heart Failure ◽  
Colony Stimulating Factor ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Stimulating Factor

SummaryCytokines regulating the mobilisation, recruitment and survival of mononuclear cells may play an important role in progression of heart failure. Therefore, we investigated the role of granulocyte colony stimulating factor (G-CSF), monocyte chemoattractant protein 1 (MCP-1) and macrophage colony stimulating factor (M-CSF) in patients with advanced heart failure. G-CSF, MCP-1 and M-CSF were determined in plasma of 351 patients with advanced heart failure by specific ELISAs. During a median follow up period of 16 months (95% confidence interval [CI]: 15–17 months) 175 patients (50%) experienced the composite endpoint rehospitalisation and all-cause mortality. M-CSF tertiles were associated with a gradually increasing risk with hazard ratios (HR) of 2.2 (95% CI: 1.5–3.2; for trend, p<0.001) for the composite endpoint and 2.6 (95% CI: 1.5–4.6; for trend, p=0.002) for all-cause mortality comparing third and first tertile. These associations remained significant in a multivariable Cox regression model after adjustment for BNP and other known risk factors (p=0.043 and p=0.024). High MCP-1 concentrations were associated with an increased risk of all-cause mortality with an adjusted HR of 1.9 (third vs. first tertile, 95% CI: 1.1–3.3; for trend, p=0.034). In contrast, G-CSF tertiles were not significantly associated with the composite endpoint or all-cause mortality in multivariable Cox regression. In conclusion, the independent and concentration-dependent association of macrophage-modulating cytokines and in particular of M-CSF with adverse outcome in advanced HF patients suggests that these cytokines may play an important pathophysiological role in progression of cardiomyopathy.

scholarly journals Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: A nationwide population-based study in Korea

2020 ◽  
Author(s):  
Jae-Hyung Roh ◽  
Jae-Hyeong Park ◽  
Hanbyul Lee ◽  
Yong-Hoon Yoon ◽  
Minsu Kim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Disease ◽  
Fatty Liver ◽  
Large Scale ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Liver Index ◽  
Fatty Liver Index ◽  
Increased Risk ◽  
New Onset

Abstract Background Heart failure (HF) is relatively common cardiovascular disease with high mortality and morbidity. Although it is associated with many cardiovascular risk factors, the association between nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease, and HF has not been evaluated in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver Index (FLI), a surrogate marker of NAFLD, to predict the development of HF in healthy individuals. Methods We evaluated 308,578 healthy persons without comorbidities who underwent the National Health check-ups in the republic of Korea from 2009 to 2014. The association between the FLI and HF was analyzed using multivariate Cox proportional-hazards models. Results During a median of 5.4 years’ follow-up, 2,532 subjects (0.8%) were newly diagnosed with HF. Subjects were categorized into quartile groups according to FLI (Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The cumulative incidence of HF was significantly higher in subjects with the highest FLI than in those with the lowest FLI (Q1, 307 [0.4%] and Q4, 890 [1.2%]; P<0.001). Adjusted hazard ratios (HRs) indicated that the highest FLI was independently associated with an increased risk for HF (HR between Q4 and Q1, 2.709; 95% confidence interval=2.380-3.085; P<0.001). FLI was significantly associated with increased risk of new-onset HF regardless of their baseline characteristics. Conclusions Higher FLI was independently associated with increased risk of HF in healthy Korean population.

scholarly journals Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: A nationwide population-based study in Korea

2020 ◽  
Author(s):  
Jae-Hyung Roh ◽  
Jae-Hyeong Park ◽  
Hanbyul Lee ◽  
Yong-Hoon Yoon ◽  
Minsu Kim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Disease ◽  
Fatty Liver ◽  
Large Scale ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Liver Index ◽  
Fatty Liver Index ◽  
Increased Risk ◽  
New Onset

Abstract Background Heart failure (HF) is relatively common cardiovascular disease with high mortality and morbidity. Although it is associated with many cardiovascular risk factors, the association between nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease, and HF has not been evaluated in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver Index (FLI), a surrogate marker of NAFLD, to predict the development of HF in healthy individuals. Methods We evaluated 308,578 healthy persons without comorbidities who underwent the National Health check-ups in the republic of Korea from 2009 to 2014. The association between the FLI and HF was analyzed using multivariate Cox proportional-hazards models. Results During a median of 5.4 years’ follow-up, 2,532 subjects (0.8%) were newly diagnosed with HF. Subjects were categorized into quartile groups according to FLI (Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The cumulative incidence of HF was significantly higher in subjects with the highest FLI than in those with the lowest FLI (Q1, 307 [0.4%] and Q4, 890 [1.2%]; P<0.001). Adjusted hazard ratios (HRs) indicated that the highest FLI was independently associated with an increased risk for HF (HR between Q4 and Q1, 2.709; 95% confidence interval=2.380-3.085; P<0.001). FLI was significantly associated with increased risk of new-onset HF regardless of their baseline characteristics. Conclusions Higher FLI was independently associated with increased risk of HF in healthy Korean population.

scholarly journals Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population: a nationwide Swedish cohort study

2021 ◽  
pp. annrheumdis-2021-219845
Author(s):  
Hannah Bower ◽  
Thomas Frisell ◽  
Daniela Di Giuseppe ◽  
Bénédicte Delcoigne ◽  
Gerd-Marie Ahlenius ◽  
...  
Keyword(s):  
Intensive Care ◽  
General Population ◽  
Cox Regression ◽  
Joint Diseases ◽  
Antirheumatic Drugs ◽  
Inflammatory Joint Diseases ◽  
Relative Risks ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Swedish Cohort

ObjectivesTo estimate absolute and relative risks for all-cause mortality and for severe COVID-19 in inflammatory joint diseases (IJDs) and with antirheumatic therapies.MethodsThrough Swedish nationwide multiregister linkages, we selected all adult patients with rheumatoid arthritis (RA, n=53 455 in March 2020), other IJDs (here: spondyloarthropathies, psoriatic arthritis and juvenile idiopathic arthritis, n=57 112), their antirheumatic drug use, and individually matched population referents. We compared annual all-cause mortality March–September 2015 through 2020 within and across cohorts, and assessed absolute and relative risks for hospitalisation, admission to intensive care and death due to COVID-19 March–September 2020, using Cox regression.ResultsDuring March–September 2020, the absolute all-cause mortality in RA and in other IJDs was higher than 2015–2019, but relative risks versus the general population (around 2 and 1.5) remained similar during 2020 compared with 2015–2019. Among patients with IJD, the risks of hospitalisation (0.5% vs 0.3% in their population referents), admission to intensive care (0.04% vs 0.03%) and death (0.10% vs 0.07%) due to COVID-19 were low. Antirheumatic drugs were not associated with increased risk of serious COVID-19 outcomes, although for certain drugs, precision was limited.ConclusionsRisks of severe COVID-19-related outcomes were increased among patients with IJDs, but risk increases were also seen for non-COVID-19 morbidity. Overall absolute and excess risks are low and the level of risk increases are largely proportionate to those in the general population, and explained by comorbidities. With possible exceptions, antirheumatic drugs do not have a major impact on these risks.

scholarly journals Body weight variability and the risk of cardiovascular outcomes in patients with nonalcoholic fatty liver disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mi Na Kim ◽  
Kyungdo Han ◽  
Juhwan Yoo ◽  
Yeonjung Ha ◽  
Young Eun Chon ◽  
...  
Keyword(s):  
Body Weight ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Large Scale ◽  
Health Examination ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
All Cause Mortality

AbstractWe investigated the association between body weight variability and the risks of cardiovascular disease and mortality in patients with nonalcoholic fatty liver disease (NAFLD) using large-scale, nationwide cohort data. We included 726,736 individuals with NAFLD who underwent a health examination between 2009 and 2010. NAFLD was defined as a fatty liver index ≥ 60, after excluding significant alcohol intake, viral hepatitis, and liver cirrhosis. Body weight variability was assessed using four indices, including variability independent of the mean (VIM). During a median 8.1-year follow-up, we documented 11,358, 14,714, and 22,164 cases of myocardial infarction (MI), stroke, and all-cause mortality, respectively. Body weight variability was associated with an increased risk of MI, stroke, and mortality after adjusting for confounding variables. The hazard ratios (HRs) (95% confidence intervals) for the highest quartile, compared with the lowest quartile, of VIM for body weight were 1.15 (1.10–1.20), 1.22 (1.18–1.26), and 1.56 (1.53–1.62) for MI, stroke, and all-cause mortality, respectively. Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in NAFLD patients. Appropriate interventions to maintain a stable weight could positively affect health outcomes in NAFLD patients.

scholarly journals Long-Term Visit-to-Visit Mean Arterial Pressure Variability and the Risk of Heart Failure and All-Cause Mortality

2021 ◽  
Vol 8 ◽  
Author(s):  
Menghui Liu ◽  
Xiaohong Chen ◽  
Shaozhao Zhang ◽  
Yifen Lin ◽  
Zhenyu Xiong ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cox Regression ◽  
Cubic Spline ◽  
Atherosclerosis Risk In Communities ◽  
Spline Curves ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Cubic Spline Curve

Background: Systolic or diastolic blood pressure (BP) variability is associated with an increased risk of cardiovascular events. We assessed whether BP variability measured by mean arterial pressure (MAP) was associated with increased risk of heart failure (HF) and death in individuals with or without hypertension.Methods: We evaluated 9,305 Atherosclerosis Risk in Communities (ARIC) study participants with or without hypertension and calculated BP variability based on MAP values from visit 1 to 4 [expressed as standard deviation (SD), average real variability (ARV), coefficient of variation (CV), and variability independent of the mean (VIM)]. Multivariate-adjusted Cox regression model and restricted cubic spline curve were used to evaluate the associations of MAP variability with all-cause mortality and HF.Results: During a median follow-up of 16.8 years, 1,511 had an HF event and 2,903 died. Individuals in the highest quartile of VIM were both associated with a 21% higher risk of all-cause mortality [hazard ratio (HR), 1.21; 95% CI, 1.09–1.35] and HF (HR, 1.21; 95% CI, 1.04–1.39) compared with the lowest quartile of VIM. Cubic spline curves reveal that the risk of deaths and HF increased with MAP variability when it reached a higher level. Results were similar in individuals with normotension (all-cause mortality: HR, 1.30; 95% CI, 1.09–1.55; HF, HR, 1.49; 95% CI, 1.12–1.98).Conclusions: In individuals with or without hypertension, greater visit-to-visit MAP variability was associated with a higher risk of all-cause mortality and HF, indicating that the BP variability assessed by MAP might be a potential risk factor for HF and death.

scholarly journals Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: A nationwide population-based study in Korea

2020 ◽  
Author(s):  
Jae-Hyung Roh ◽  
Jae-Hyeong Park ◽  
Hanbyul Lee ◽  
Yong-Hoon Yoon ◽  
Minsu Kim ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Disease ◽  
Fatty Liver ◽  
Large Scale ◽  
Surrogate Marker ◽  
Cox Proportional Hazards ◽  
Liver Index ◽  
Fatty Liver Index ◽  
Increased Risk ◽  
New Onset

Abstract Background Heart failure (HF) is relatively common cardiovascular disease with high mortality and morbidity. Although it is associated with many cardiovascular risk factors, the association between nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease, and HF has not been evaluated in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver Index (FLI), a surrogate marker of NAFLD, to predict the development of HF in healthy individuals. Methods We evaluated 308,578 healthy persons without comorbidities who underwent the National Health check-ups in the republic of Korea from 2009 to 2014. The association between the FLI and HF was analyzed using multivariate Cox proportional-hazards models. Results During a median of 5.4 years’ follow-up, 2,532 subjects (0.8%) were newly diagnosed with HF. Subjects were categorized into quartile groups according to FLI (Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The cumulative incidence of HF was significantly higher in subjects with the highest FLI than in those with the lowest FLI (Q1, 307 [0.4%] and Q4, 890 [1.2%]; P<0.001). Adjusted hazard ratios (HRs) indicated that the highest FLI was independently associated with an increased risk for HF (HR between Q4 and Q1, 2.709; 95% confidence interval=2.380-3.085; P<0.001). FLI was significantly associated with increased risk of new-onset HF regardless of their baseline characteristics. Conclusions Higher FLI was independently associated with increased risk of HF in healthy Korean population.

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