Tuesday, June 25, 2013

Research shows strong link between liver disease, cardiovascular disease risk

Saint Luke’s collaborative research shows strong link between liver disease, cardiovascular disease risk

Fatty liver disease growing concern among clinicians

KANSAS CITY, Mo. (June 20, 2013) — Non-alcoholic fatty liver disease (NAFLD) affects up to a third of the general population, and in most cases causes no signs, symptoms, or complications. Now liver specialists and cardiologists at Saint Luke’s are adding to a growing body of research indicating a direct link between NAFLD and a high risk for cardiovascular disease. The research is compelling enough that cardiologists at Saint Luke’s are considering changing their practices to include liver and spleen images in CT scans as a screening indicator of coronary artery disease risk. 
Saint Luke’s Liver Disease Management Center gastroenterologists Rajiv Chhabra, M.D., and John Helzberg, M.D., presented new research at the Digestive Disease Week conference of the American Gastroenterological Association Annual Meeting in May. Their study showed that as independent conditions, NAFLD and coronary artery disease are strongly predictive of each other. Cardiologists James O’Keefe, M.D., and Randall Thompson, M.D., also contributed to the research. 
The study assessed upper abdominal CT images from 377 non-symptomatic patients undergoing non-contrast CT scans to determine coronary calcium scores. Using expanded imaging “windows” to include the liver and spleen, researchers found that patients with fatty liver disease were more likely to also have coronary artery disease. The link between the two was stronger than other more traditional risk factors for coronary artery disease, such as smoking, hypertension, male gender, diabetes, high cholesterol, or metabolic syndrome. 
Non-alcoholic fatty liver disease is the accumulation of fat in the liver in people who drink little to no alcohol. The fat can cause inflammation and scarring in the liver. Its most serious form can progress to cirrhosis, liver failure, or liver cancer. It is the most common liver disorder among Western countries and one of the fastest growing concerns among clinicians due to escalating obesity and diabetes.  
“If current trends continue, the prevalence of NAFLD is expected to increase to 40 percent of the population by 2020,” said Dr. Helzberg.
While more research is needed to explore the relationship between the two conditions, the growing number of patients with NAFLD suggests a potential role for increased screening among the medical community. “These findings suggest that patients with coronary artery disease should be screened for liver disease, and likewise NAFLD patients should be evaluated for coronary artery disease,” said Dr. Chhabra. Treatments now primarily include lifestyle changes like diet, exercise, and increased monitoring. 
A research partnership between physicians at Saint Luke’s Liver Disease Management Center and Saint Luke’s Mid America Heart Institute continues to explore the issue. Funding was provided through a research grant from the Saint Luke’s Foundation.
“This study is another example of what can arise from cross-disciplinary collaboration that is increasingly common at Saint Luke’s. By pooling our knowledge and insights, we are able to identify promising areas for research that may have a powerful impact on our ability to practice medicine and to improve the lives of our patients,” said David J. Cohen, M.D., M.Sc., director of Cardiovascular Research at Saint Luke’s Hospital.  
About Saint Luke’s Liver Disease Management Center
At Saint Luke’s Liver Disease Management Center, patients throughout the Midwest and across the United States have access to liver disease treatment options provided by a multidisciplinary physician group. From preventive care to liver transplantation, Saint Luke’s provides a full range of services for patients with disorders of the liver, bile ducts, and pancreas.
About Saint Luke’s Mid America Heart Institute
Saint Luke’s Mid America Heart Institute, a member of Saint Luke’s Health System and a teaching affiliate of the University of Missouri-Kansas City, is one of the preeminent cardiovascular programs in the country. Its legacy of innovation began more than 25 years ago when it opened as the nation’s first heart hospital. Since then, the Heart Institute has earned a world-wide reputation for excellence in the treatment of heart disease, including interventional cardiology, cardiovascular surgery, imaging, heart failure, transplant, heart disease prevention, women’s heart disease, electrophysiology, outcomes research, and health economics.  With more than 50 full-time board certified cardiovascular specialists on staff, the Heart Institute offers one of the largest heart failure/heart transplant programs in the country, has the largest experience with transcatheter aortic valve replacement in the Midwest, and is a global teaching site for the newest approaches to opening challenging blocked arteries using minimally invasive techniques.


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