The association between non-alcoholic fatty liver disease and valvular heart disease

Treatment with phosphatidylcholine of patients with nonalcoholic fatty liver disease: a prospective pilot study

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is characterized by a complex clinical picture that includes nonalcoholic steatohepatitis and cirrhosis. In the last decades, several studies have shown that NAFLD increases the risk of cardiovascular diseases. In a prospective pilot study, the benefit of treatment with phosphatidylcholine in NAFLD patients has been assessed.

METHODS

Thirty patients with NAFLD were enrolled. All received treatment with phosphatidylcholine (Essentiale^® Forte N; Sanofi, Paris, France) 300 mg capsules, administered 2 at time orally, 3 times a day with meals for three months. The clinical and laboratory parameters before and after treatment were compared.

RESULTS

After the administration of Essentiale^® Forte N (Sanofi) the level of alanine aminotransferase (ALT) decreased by 59.6% (P<0.05) and that of aspartate transaminase (AST) decreased by 75.4% (P<0.05). Moreover, after treatment, an increase in antioxidant enzymes superoxide dismutase by 48% (P<0.05) and glutathione peroxidase by 48.1% (P<0.05) was observed.

CONCLUSIONS

The results of the study indicate that treatment with Essentiale^® Forte N (Sanofi) for 3 months was associated with a significant decrease in transaminase levels, in the activity of lipid peroxidation markers and with an increase in the level of antioxidant enzymes.

Interplay between Heart Disease and Metabolic Steatosis: A Contemporary Perspective

The liver-heart axis is a growing field of interest owing to rising evidence of complex bidirectional interplay between the two organs. Recent data suggest non-alcoholic fatty liver disease (NAFLD) has a significant, independent association with a wide spectrum of structural and functional cardiac diseases, and seems to worsen cardiovascular disease (CVD) prognosis. Conversely, the effect of cardiac disease on NAFLD is not well studied and data are mostly limited to cardiogenic liver disease. We believe it is important to further investigate the heart-liver relationship because of the tremendous global health and economic burden the two diseases pose, and the impact of such investigations on clinical decision making and management guidelines for both diseases. In this review, we summarize the current knowledge on NAFLD diagnosis, its systemic manifestations, and associations with CVD. More specifically, we review the pathophysiological mechanisms that govern the interplay between NAFLD and CVD and evaluate the relationship between different CVD treatments and NAFLD progression.