Association between cardiac conduction defect and nonalcoholic fatty liver disease: a systematic review and meta-analysis

Karn Wijarnpreecha; Panadeekarn Panjawatanan; Paul T Kroner; Wisit Cheungpasitporn; Patompong Ungprasert

doi:10.20524/aog.2020.0535

Association between cardiac conduction defect and nonalcoholic fatty liver disease: a systematic review and meta-analysis

Ann Gastroenterol. 2020 Nov-Dec;33(6):661-666. doi: 10.20524/aog.2020.0535. Epub 2020 Sep 16.

Authors

Karn Wijarnpreecha¹, Panadeekarn Panjawatanan², Paul T Kroner¹, Wisit Cheungpasitporn³, Patompong Ungprasert⁴

Affiliations

¹ Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Jacksonville, Florida, USA (Karn Wijarnpreecha, Paul T. Kroner).
² Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA (Panadeekarn Panjawatanan).
³ Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, USA (Wisit Cheungpasitporn).
⁴ Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (Patompong Ungprasert).

Abstract

Background: Cardiovascular disease is a common comorbidity of patients with nonalcoholic fatty liver disease (NAFLD), particularly coronary artery disease and congestive heart failure. However, the relation between NAFLD and cardiac conduction defects has not been well studied. This systematic review and meta-analysis was conducted to identify all available studies on this association and summarize their results.

Methods: A comprehensive literature review was conducted using MEDLINE and EMBASE databases through June 2020 to identify studies that compared the risk of a cardiac conduction defect among patients with NAFLD versus those without. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird.

Results: Three cross-sectional studies with 3651 participants fulfilled the eligibility criteria and were included in this meta-analysis. The risk of a cardiac conduction defect was significantly higher among patients with NAFLD than in those without NAFLD, with a pooled odds ratio of 5.17 (95% confidence interval 1.34-20.01; I ² 96%).

Conclusion: A significantly greater risk of cardiac conduction defects among patients with NAFLD was observed in this meta-analysis. How this risk should be managed in clinical practice requires further investigation.

Keywords: Nonalcoholic fatty liver disease; cardiac conduction defect; heart block; meta-analysis; nonalcoholic steatohepatitis.