Whole blood viscosity as a predictor of left ventricular dysfunction in patients with Non-Alcoholic Fatty Liver Disease (NAFLD)

Background: NAFLD is the commonest liver pathology globally which is distinguished by hepatic steatosis without evidence of secondary injurious hepatic agents.The spectrum of liver affection in NAFLD is variable starting from mild steatosis to evident fibrosis and may extend to extra hepatic morbidities.CVD is one of the highly serious systemic comorbidities of NAFLD including various degrees of cardiovascular dysfunction especially at the level of left ventricle.Whole blood viscosity (WBV) is an important rheological parameter that affects blood flow in the circulation with subsequent affection of tissue perfusion, so investigators try to elucidate the role of WBV as a crucial player in the etiopathogenesis of LVD in NAFLD cases and hence its use as an early preditictor marker.Patients and Methods: This is a cross sectional study that was carried out on 50 NAFLD cases grouped into 2 groups based on the existence presence of LVD: Group 1 included 26 patients with LVD, group 2 included 24 patients without LVD. The patients’ demographic, clinical, laboratory and radiological data were recorded on a special observation sheet. Whole blood viscosity and ECHO cardiography assessment of the left ventricular function of patients were also recorded. Statistical analysis was done for all collected data using the IBM, SPSS version 23. Significance of obtained results was considered at p-value of less than 0.05.Results: WBV was significantly increased in group 1 compared to group 2. WBV had appeared to be an excellent predictor of LVD in patients with NAFLD; it was positively correlated with hemoglobin, hematocrit, fatty liver status and fibrosis and all LVD parameters except for ejection fraction and relative wall thickness. By logistic regression analysis hemoglobin, whole blood viscosity, and left ventricular end-diastolic diameter are the only predictors in NAFLD patients with LVD. WBV at a cut-off value of 4.38; the AUC was 0.756, the sensitivity was 96.15%, the specificity was 83.33%, the PPV was 86.20%, and the NPV was 95.23%.Conclusion: WBV is a good, easily obtained and affordable marker for the determination of LVD in cases with NAFLD.