[PREDICTION OF LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEART FAILURE AND METABOLIC SYNDROME].

Abstract

Currently, the non-alcoholic fatty liver disease (NAFLD) is recognized as the most common chronic liver disease. 27.8% of patients with NAFLD have diseases of the cardiovascular system (cardiovascular), which are the leading cause of death in patients with NAFLD.

Objective: To study the probability of liver fibrosis in patients with metabolic syndrome and chronic heart failure (CHF).

Materials and methods: The study included 77 patients with CHF. The diagnosis of CHF was confirmed by the qualitative measurement of NT-proBNP. The severity of the clinical manifestations of heart failure, functional status of the patient was assessed. All patients underwent clinical and biochemical blood tests, ECG, ultrasound examination of the liver. The size of the heart chambers, wall thickness of the myocardium and epicardial fat were evaluated by echocardiography. The NAFLD Fibrosis Score (NFS) was calculated in all patients enrolled in the study.

Results: In the study group patients The direct correlations between the value of NFS: weight (r = 0,38; p = 0,001), glucose levels (r = 0,54; p = 0,001), the level of glycosylated hemoglobin (r = 0,51; p = 0,002), LV myocardium mass (r = 0, 51; p = 0,005), the sizes of the right atrium (RA) (r = 0,45; p = 0,013), sizes of the left atrium (LA) (r = 0,41; p = 0,023) were found in the study group patients. Inverse correlation between the value of NFS: total cholesterol (r = -0,43; p = 0,008), epicardial fat thickness (EFT) (r = 0,29; p = 0,014), end-diastolic (CD) left ventricular size (r = 0,27; p = 0,02), end-systolic (CS), left ventricular size (r = 0,27; p = 0,02), CD ventricular volume (r = 0,25; p = 0,02), CS LV volume (r = 0,28; p = 0,02). NFS is correlated with the six-minute walk test (6MWT) (p = 0,023; U-Mann-Whitney). Using the NAFLD fibrosis score in internist routine practice help to identify patients with NAFLD and cardiovascular diseases by non-invasive way in the early stages of the disease and to adjust the current treatment, if necessary.