Non-alcoholic fatty liver disease and heart valve disease: a neglected link

An Overview of Sport Participation and Exercise Prescription in Mitral Valve Disease

The incidence of heart valve disease (HVD) has been rising over the last few decades, mainly due to the increasing average age of the general population, and mitral valve (MV) disease is the second most prevalent HVD after calcific aortic stenosis, but MV disease is a heterogeneous group of different pathophysiological diseases. It is widely proven that regular physical activity reduces all-cause mortality rates, and exercise prescription is part of the medical recommendations for patients affected by cardiovascular diseases. However, changes in hemodynamic balance during physical exercise (including the increase in heart rate, preload, or afterload) could favor the progression of the MV disease and potentially trigger major cardiac events. In young patients with HVD, it is therefore important to define criteria for allowing competitive sport or exercise prescription, balancing the positive effects as well as the potential risks. This review focuses on mitral valve disease pathophysiology, diagnosis, risk stratification, exercise prescription, and competitive sport participation selection, and offers an overview of the principal mitral valve diseases with the aim of encouraging physicians to embody exercise in their daily practice when appropriate.

Role of non-alcoholic fatty liver disease in development of cardiovascular disease

With the improvement of the economic level and changes in dietary structure and lifestyle, the incidence of non-alcoholic fatty liver disease (NAFLD) has been increasing. It has gradually become the main cause of chronic liver diseases in the world. Cardiovascular disease (CVD) is the main cause of death in NAFLD patients, and more and more studies have found that there is a correlation between the two conditions. NAFLD patients are at greater risk of developing CVD than normal patients. Associated mechanisms may be related to dysfunction of blood vessels and endothelial cells, bile acid metabolism, oxidative stress, systemic inflammation, and activation of the renin-angiotensin system. Among them, metabolic syndrome plays an important role. Therefore, early identification of cardiovascular disease-related risk factors in NAFLD patients and thereby reducing cardiovascular-related complications are essential to improve the prognosis of those patients.