FUNCTIONAL STATUS OF THE LIVER IN CARDIOVASCULAR DISEASES

Аннотация

Cardiovascular diseases and liver diseases are closely related. Non-alcoholic fatty liver disease has the same risk factors as those for atherosclerotic cardiovascular disease and may also be a risk factor for atherosclerotic cardiovascular disease on its own. Heart failure causes liver fibrosis, and liver fibrosis results in worsened cardiac preload and congestion. Although some previous reports regard the association between cardiovascular diseases and liver disease, the management strategy for liver disease in patients with cardiovascular diseases is not still established. Keywords: liver disease; heart failure; atherosclerotic cardiovascular disease; non- alcoholic fatty liver disease. ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ ПЕЧЕНИ ПРИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЯХ Аннотация. Сердечно-сосудистые заболевания и заболевания печени тесно связаны. Неалкогольная жировая болезнь печени имеет те же факторы риска, что и атеросклеротические сердечно-сосудистые заболевания, и может также быть фактором риска атеросклеротических сердечно-сосудистых заболеваний сама по себе. Сердечная недостаточность вызывает фиброз печени, а фиброз печени приводит к ухудшению сердечной преднагрузки и застоя. Хотя некоторые предыдущие отчеты рассматривают связь между сердечно-сосудистыми заболеваниями и заболеваниями печени, стратегия лечения заболеваний печени у пациентов с сердечно-сосудистыми заболеваниями все еще не установлена. Ключевые слова: заболевание печени; сердечная недостаточность; атеросклеротическое сердечно-сосудистое заболевание; неалкогольная жировая болезнь печени. Despite initiation of new therapies, both the short- and long-term mortality rate of patients with heart failure is still high. This may be at least partly attributable to frequently present comorbidities. Heart failure itself is characterized by impaired organ perfusion resulting from both forward failure and increased central venous pressure (backward failure). We recently showed that both forward and backward failure are the most important determinants of renal dysfunction 1920 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 4 in heart failure. Liver function abnormalities are frequently found in patients with heart failure and are related to a poor outcome. Individual small reports have highlighted the importance of either high central venous pressure or reduced hepatic perfusion. However, the relative contribution of reduced perfusion (forward failure) or venous congestion (backward failure) in causing alterations in specific markers of liver function has not been established. In patients with non-alcoholic fatty liver disease (NAFLD), (cardiovascular diseases) CVD is the most important comorbidity as well as liverassociated complications. CVD is the most common cause of death in these patients. ASCVD and NAFLD share the same risk factors, such as dyslipidemia, diabetes mellitus, and obesity; however, NAFLD itself is considered a promoting factor for ASCVD. NAFLD is associated with dyslipidemia, oxidative stress, microbiome disturbances, chronic inflammation, insulin resistance, coagulation disorders, and endothelial dysfunction, and these factors might also be associated with CVD. Owing to these factors, NAFLD has a strong association with prognosis in CVD. NAFLD is associated with abnormal lipid metabolism and altered glucose metabolism. Patients with NAFLD tend to have high triglyceride concentrations, high low-density lipoprotein concentrations, oxidated low-density lipoprotein and remnant cholesterol, and low high-density lipoprotein concentrations, which are established risk factors for ASCVD. Dyslipidemia can become one of the causes of NAFLD and also be worsened by NAFLD. Elevated plasma insulin and glucose levels, which are caused by diabetes mellitus and insulin resistance, and excess plasma lipid lead to increased de novo lipogenesis and decreased intracellular triglyceride hydrolysis. This increases hepatic triglyceride content, which causes increased plasm triglyceride levels. In addition, increased intracellular cholesterol in the liver reduced membrane-bound low-density lipoprotein receptor and low-density lipoprotein uptake to the liver. These changes contribute to increased large very-low-density lipoprotein 1 and small dense low-density lipoprotein, which finally accelerate atherosclerosis. Notably, the Mediterranean diet and antioxidant formulation efficiently improve anthropometric parameters, lipid profile, and insulin sensitivity and reduce hepatic fat accumulation and liver stiffness in patients with NAFLD as preventive management. Because the therapeutic strategy for NAFLD has not been established yet, diet therapy may be one of the few efficient therapies for patients with NAFLD. Liver Function Testing Laboratory measurements were extracted from samples drawn within 3 days before catheterization. Liver function tests that were extracted included aspartate aminotransferase (AST, upper limit of normal [ULN] 40 U/L), alanine aminot