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Whether NAFLD is independently associated with subclinical myocardial remodeling or dysfunction among the general population is unknown. We performed a cross\u2010sectional analysis of 2,713 participants from the multicenter, community\u2010based Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent concurrent computed tomography (CT) quantification of liver fat and comprehensive echocardiography with myocardial strain measured by speckle tracking during the Year\u201025 examination (age, 43\u201055 years; 58.8% female and 48.0% black). NAFLD was defined as liver attenuation \u226440 Hounsfield units after excluding other causes of liver fat. Subclinical left ventricular (LV) systolic dysfunction was defined using values of absolute peak global longitudinal strain (GLS). Diastolic dysfunction was defined using Doppler and tissue Doppler imaging markers. Prevalence of NAFLD was 10.0%. Participants with NAFLD had lower early diastolic relaxation (e\u2019) velocity (10.8\u2009\u00b1\u20092.6 vs. 11.9\u2009\u00b1\u20092.8 cm\/s), higher LV filling pressure (E\/e\u2019 ratio: 7.7\u2009\u00b1\u20092.6 vs. 7.0\u2009\u00b1\u20092.3), and worse absolute GLS (14.2\u2009\u00b1\u20092.4% vs. 15.2\u2009\u00b1\u20092.4%) than non\u2010NAFLD (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.0001 for all). When adjusted for HF risk factors or body mass index, NAFLD remained associated with subclinical myocardial remodeling and dysfunction (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.01). The association of NAFLD with e\u2019 velocity (\u03b2\u2009=\u2009\u22120.36 [standard error\u2009=\u20090.15] cm\/s;<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02), E\/e\u2019 ratio (\u03b2\u2009=\u20090.35 [0.16];<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.03), and GLS (\u03b2\u2009=\u2009\u22120.42 [0.18]%;<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.02) was attenuated after controlling for visceral adipose tissue. Effect modification by race and sex was not observed.<jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>NAFLD is independently associated with subclinical myocardial remodeling and dysfunction and provides further insight into a possible link between NAFLD and HF. (H<jats:sc>epatology<\/jats:sc>2015;62:773\u2013783)<\/jats:p>","DOI":"10.1002\/hep.27869","type":"journal-article","created":{"date-parts":[[2015,4,24]],"date-time":"2015-04-24T22:14:34Z","timestamp":1429913674000},"page":"773-783","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":269,"title":["Association of nonalcoholic fatty liver disease with subclinical myocardial remodeling and dysfunction: A population\u2010based study"],"prefix":"10.1097","volume":"62","author":[{"given":"Lisa B.","family":"VanWagner","sequence":"first","affiliation":[{"name":"Departments of Preventive Medicine and Medicine,Northwestern University,Chicago,IL"},{"name":"Division of Gastroenterology & Hepatology,Northwestern University,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"Wilcox","sequence":"additional","affiliation":[{"name":"Departments of Preventive Medicine and Medicine,Northwestern University,Chicago,IL"},{"name":"Division of Cardiology,Northwestern University,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Colangelo","sequence":"additional","affiliation":[{"name":"Departments of Preventive Medicine and Medicine,Northwestern University,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald M.","family":"Lloyd\u2010Jones","sequence":"additional","affiliation":[{"name":"Departments of Preventive Medicine and Medicine,Northwestern University,Chicago,IL"},{"name":"Division of Cardiology,Northwestern University,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Jeffrey","family":"Carr","sequence":"additional","affiliation":[{"name":"Departments of Radiology,Cardiovascular Medicine and Biomedical Informatics, Vanderbilt University School of Medicine,Nashville,TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao A.","family":"Lima","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Radiology,Johns Hopkins University School of Medicine,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Medicine,Division of Preventive Medicine,University of Alabama Birmingham School of Medicine,Birmingham,AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Rinella","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology,Northwestern University,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv 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