Development of a Nomogram for Estimating the Risk of Left Ventricular Diastolic Dysfunction in Patients with Non-Alcoholic Fatty Liver Disease

Diabetes Metab Syndr Obes. 2022 Jun 9:15:1749-1759. doi: 10.2147/DMSO.S371208. eCollection 2022.

Abstract

Background: Patients with non-alcoholic fatty liver disease (NAFLD) are more likely to develop left ventricular diastolic dysfunction (LVDD). Although lifestyle adjustments contribute to the improvement of NAFLD, thereby delaying or even preventing LVDD progression, it is difficult to maintain a healthy lifestyle, resulting in a higher incidence of LVDD in NAFLD patients.

Objective: This study aims to develop a nomogram for assessing the risk of LVDD progression in NAFLD patients to increase their adherence to therapeutic interventions and adjust their treatment regimens timely.

Methods: A total of 148 medical records of NAFLD patients were retrospectively analyzed. Sixty-three were assigned to the LVDD+ group and 85 were assigned to the LVDD- group. The independent correlates of LVDD, which were screened via least absolute shrinkage and selection operator logistic regression model first, followed by multivariate Logistic regression model, constituted the nomogram to determine the likelihood of LVDD in NAFLD patients.

Results: Number of comorbidities, glycosylated hemoglobin, and epicardial adipose tissue (EAT) volume index were independent correlates of LVDD (all P < 0.05). They served as components in the newly developed nomogram. It obtained significant clinical benefit in detecting NAFLD patients at the risk of LVDD progression, with satisfied discrimination and calibration.

Conclusion: We developed a nomogram for identifying NAFLD patients with a normal diastolic function who are at risk of LVDD progression, thus contributing to effective prevention of LVDD progression.

Keywords: cardiac magnetic resonance; epicardial adipose tissue; left ventricular diastolic dysfunction; nomogram; non-alcoholic fatty liver disease.

Grants and funding

Medical Scientific Research Foundation of Zhejiang Province, China (2020KY854), Medical Scientific Research Foundation of Zhejiang Province, China (2018KY696), Ningbo Public Service Technology Foundation, China (202002N3184), and Research Foundation of Hwa Mei Hospital, University of Chinese Academy of Sciences, China (2018HMKY27).