First-in-Human Experience With Impella 5.0/5.5 for High-Risk Patients With Advanced Heart Failure Undergoing VT Ablation

医学 脂肪变性 高甘油三酯血症 胃肠病学 代谢综合征 内科学 脂肪肝 心力衰竭 人口 纤维化 甘油三酯 疾病 胆固醇 肥胖 环境卫生
作者
Jakub Sroubek,Ramya Vajapey,Joseph Sipko,Edward G. Soltesz,Aaron Weiss,Mandeep Bhargava,Ayman A. Hussein,Mohamed Kanj,Walid Saliba,Tyler Taigen,Oussama Wazni,Pasquale Santangeli
出处
期刊:Journal of the American College of Cardiology [Elsevier BV]
卷期号:82 (5): 469-471
标识
DOI:10.1016/j.jacc.2023.05.012
摘要

Chylomicronemia syndrome is a form of severe hypertriglyceridemia (HTG) caused by the familial chylomicronemia syndrome (FCS) or multifactorial chylomicronemia syndrome (MCS). Non-alcoholic fatty liver disease (NAFLD) has been associated with components of the metabolic syndrome and is more prevalent in subjects with elevated triglycerides.The primary objective was to compare the prevalence of hepatic steatosis assessed by conventional imaging between HTG groups (FSC, MCS and moderate HTG (mHTG)). The secondary objective was to determine the difference in the prevalence of liver fibrosis.This cross-sectional observational study was performed on adult patients from the lipid clinic of the Montreal Clinical Research Institute (IRCM). We retrospectively reviewed the imaging reports available in the patients’ files for signs of NAFLD. We also used the FIB-4 index as a surrogate marker of liver fibrosis.We reviewed the medical file of 300 patients; 22 with FCS, 82 with MCS and 196 with mHTG. There was significantly more hepatic steatosis in the MCS group compared to the mHTG and FCS groups (79%, 66% and 43% respectively p=0.02). There was a significantly higher prevalence of subjects within the “unlikely fibrosis” category in the mHTG group (91%) compared to the MCS (84%) and FCS group (59%), p=0.0004.We found that the prevalence of hepatic steatosis was 3-, 2.5-, and 2-fold higher in MCS, mHTG and FCS patients than in the general population. This suggests that patients with elevated triglycerides, regardless of the underlying etiology, are at higher risk of hepatic steatosis and NAFLD.
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