UNLOCKING THE HEARTLIVER CONNECTION: EXPLORING DIASTOLIC HEART FAILURE RISK IN MASLD PATIENTS DEVOID OF CARDIOVASCULAR HISTORY

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Hepatology

Abstract

Background: MASLD, ranging from nonalcoholic fatty liver to MASH, shares metabolic risk factors with CVD, which is the leading cause of death in MASLD patients. While the association between MAFLD and heart failure with reduced ejection fraction (HFrEF) is established, the link with HFpEF is emerging, yet evidence remains scarce. This study aims to explore the risk and predictors of new-onset heart failure with preserved ejection fraction (HFpEF) in patients with a history of MASH but without prior CVD. Methods: This study analyzed data from 81,309 MASH patients from the 2016 National Inpatient Sample (NIS) to examine adult patients ( > 18 years) diagnosed with MASH. Patients with prior coronary artery disease and heart failure were excluded. Using ICD-10 codes, new-onset heart failure with preserved ejection fraction (HFpEF) was identified as the primary disease leading to hospitalization in MASLD patients without prior CVD. Demographics, baseline characteristics, and comorbidities were compared between MASH patients with and without new-onset HFpEF. The study also investigated predictors of new-onset HFpEF in MASH patients without prior CVD, utilizing multivariate analysis to adjust for various factors including age, gender, race, comorbidities, and hospital characteristics. STATA software was employed for statistical analyses. Results: In this retrospective study, 71.1% of patients lacked prior CVD and were analyzed. New-onset HFpEF occurred in 1.1% (n = 645) of these patients (OR 1.2 [1.01 to 1.44], P = 0.042). Comparatively, those with newonset HFpEF were older (65.7 ± 0.9 vs 58 ± 0.2, P < 0.001), predominantly female (75.9% vs 64.2%, P = 0.008), and had a higher percentage of white race (P = 0.016). They were also more likely to have dyslipidemia (39.5% vs 28.6%, P = 0.005), CKD (38.7% vs 18.5%, P < 0.001), OSA (34.9% vs 15.5%, P = 0.001), and AF (20.7% vs 4.6%, P < 0.001) as seen in Table-1. Multivariate analysis revealed older age (Coef. 1.03 per year [1.01 to 1.05], P < 0.001), female gender (OR 2.1 [1.34 to 3.24], P = 0.001), Native American race (OR 3.0 [1.22 to 7.48], P = 0.017), OSA (OR 3.1 [2.01 to 4.63], P < 0.001), AF (OR 3.7 [2.31 to 5.94], P < 0.001), and CKD (OR 1.9 [1.16 to 3.21], P < 0.001) as predictors of newonset HFpEF in MASH patients without prior CVD as seen in Table-2. Conclusion: The current study demonstrated an association between MASH and new-onset HFpEF in patients without a prior history of CVD. Predictors of developing HFpEF in patients with MASH include older age, female gender, Native American race, history of AF, OSA, and CKD. Such findings highlight the importance of risk factor recognition and identification of susceptible groups in patients with MASH who are at risk of developing HFpEF. The growing body of evidence demonstrating the association between both diseases calls for further investigations to well establish the mechanism, risk factors, and morbidity of HFpEF in patients with MASH.

Volume

80

First Page

S470

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