Impact of metabolic dysfunction-associated fatty liver disease on left ventricular function and myocardial strain in patients with ASTEMI: Insights from a 3.0-T cardiac magnetic resonance study.

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to adverse cardiovascular outcomes in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Nonetheless, its impact on left ventricular dysfunction and myocardial strain in this population is yet to be elucidated. Therefore, this study aimed to determine the effect of MAFLD on left ventricular function and strain parameters in patients with ASTEMI using cardiac magnetic resonance (CMR).

Methods: This retrospective study included 318 patients with ASTEMI (113 MAFLD and 205 non-MAFLD) undergoing CMR and non-enhanced computed tomography. Left ventricular function, global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) were compared between the two groups. Univariate and multivariate linear regression analyses were performed to examine the effect of MAFLD on left ventricular function and global strain in patients with ASTEMI.

Results: Patients with MAFLD demonstrated significantly lower left ventricular ejection fraction (LVEF) (53.35 % vs. 59.64 %, P < 0.001), left ventricular global function index (LVGFI) (27.24 vs. 29.23, P = 0.006), and reduced absolute values of global strain in all three directions (GRS: 16.90 % vs. 18.80 %; GCS: 11.90 % vs. 12.90 %; GLS: 8.80 % vs. 10.90 %; all P < 0.001). Multivariate analysis confirmed that MAFLD was an independent predictor of LVEF (β = -0.112, P = 0.028), LVGFI (β = - 0.109, P = 0.034), and multidirectional strain parameters (GRS, GCS, and GLS) (all P < 0.05). Moreover, increased MAFLD severity was correlated with a numerical deterioration in both left ventricular function parameters and global strain values.

Conclusion: MAFLD independently exacerbates left ventricular dysfunction and myocardial deformation in patients with ASTEMI, emphasizing its role in postinfarction risk stratification and management.