Evaluation of Subclinical Myocardial Dysfunction Using Tissue Doppler Imaging Echocardiography in Children with Non-Alcoholic Fatty Liver Disease

Abstract
Background: Pediatric Non-Alcoholic Fatty Liver Disease (NAFLD) is a global health problem worldwide and is con-sidered the most common cause of chronic liver disease in pediatrics. Both NAFLD and heart failure are obesity-related conditions with high cardiovascular morbidity and mortality that have reached epidemic proportions.
Aim of Study: Evaluate subclinical myocardial dysfunc-tion using Tissue Doppler imaging Echocardiography in a group of overweight/obese children and adolescents with NAFLD.
Patients and Methods: This prospective case-control study was carried out upon 80 children (40 cases with NAFLD, 20 cases obese without NAFLD and 20 healthy controls). Diag-nosis of NAFLD was based on the finding of hepatic steatosis detected by abdominal ultrasonography. These children un-derwent full examination, lab investigations and TDI echocar-diography.
Results: Using conventional echocardiography mean value of LV mass was significantly higher in patients with NAFLD compared to controls. Using TDI mean values of MPI was significantly higher in patients compared to controls, whereas other parameter showed no significant difference. Left ven-tricular mass by echo showed significant increase as the hepatic steatosis was advancing in severity.
Conclusion: Patients with NAFLD have evidence of subclinical myocardial dysfunction using TDI echocardi-ography. Although the TDI provides new insight into alter-ations in LV structure and function related to IR in NAFLD patients, it cannot be used for differentiation of steatosis grading.