University of Oulu

Käräjämäki AJ, Kettunen O, Lepojärvi S,Koivurova O-P, Kesäniemi YA, Huikuri H, et al.(2017) Presence of atrial fibrillation is associated with liver stiffness in an elderly Finnish population.PLoS ONE 12(3): e0173855. https://doi.org/10.1371/journal.pone.0173855

Presence of atrial fibrillation is associated with liver stiffness in an elderly Finnish population

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Author: Käräjämäki, Aki Juhani1,2,3; Kettunen, Olli4; Lepojärvi, Samuli5,2;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
2University of Oulu, Oulu, Finland
3 Abdominal Center, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
4 Abdominal Center, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
5Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital,Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe201704186182
Language: English
Published: Public Library of Science, 2017
Publish Date: 2017-04-18
Description:

Abstract

Background: Chronic liver injury from different etiologies drives liver fibrosis. However, little is known about the associated factors, systemic factors in particular. Recently, non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation have been shown to be associated with each other. Thereby, we aimed to study the association between atrial fibrillation and liver stiffness.

Study: Extensive clinical measurements including echocardiography of the heart, transient elastography (TE) of the liver and the presence of atrial fibrillation were determined in elderly Finnish study subjects (n = 76, mean age 73 years) from OPERA (Oulu Project Elucidating the Risk of Atherosclerosis) study cohort. Half of the study subjects had non-alcoholic fatty liver disease, whereas others did not have any known hepatic morbidity. The present study was cross-sectional by nature.

Results: The subjects with atrial fibrillation had higher TE values (with atrial fibrillation TE = 9.3kPa, without atrial fibrillation TE = 6.3kPa, p = 0.018). When the cohort was divided to four subgroups (those without NAFLD or atrial fibrillation, with NAFLD but without atrial fibrillation, with both conditions, and with atrial fibrillation but without NAFLD), the TE value was the highest in the subjects with both conditions (5.3kPa, 7.4kPa, 10.8kPa and 7.8kPa, respectively, p = 0.019). Moreover, the higher the TE value, the more prevalent atrial fibrillation was (the atrial fibrillation prevalence by tertiles of TE 27% / 36% / 77%, p = 0.001). Likewise, the greater the TE value, the greater the left atrial diameter, a collateral of atrial fibrillation (left atrial diameters by tertiles of TE 39mm / 45mm / 48mm, p"<"0.001) was. All these p-values for continuous variables remained statistically significant even after adjustment for common clinically relevant risk factors.

Conclusions: There is an association between atrial fibrillation and liver stiffness. This novel association may have multiple explanations and mechanistic links, which are discussed here and need further studies, prospective studies in particular.

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Series: PLoS one
ISSN: 1932-6203
ISSN-E: 1932-6203
ISSN-L: 1932-6203
Volume: 3
Issue: 12
Article number: e0173855
DOI: 10.1371/journal.pone.0173855
OADOI: https://oadoi.org/10.1371/journal.pone.0173855
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 Internal medicine
Subjects:
Funding: AJK was granted from the Medical Association of Vaasa, Vaasa, Finland. The study was funded by the Finnish Foundation for Cardiovascular Research.
Dataset Reference: All relevant data are within the paper.
Copyright information: ©2017 Käräjämäki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
  https://creativecommons.org/licenses/by/4.0/