{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:16:36Z","timestamp":1792019796900,"version":"4.4.0"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Technology (Taiwan)","award":["NSC-101-2314-B-195-020, NSC103-2314-B-010-005-MY3, 103-2314-B-195-001-MY3, 101-2314-B-195-020 \u2013MY1, MOST 103-2314-B-195-006-MY3, NSC102-2314-B-002-046-MY3, 106-2314-B-195 -008-MY2, 108-2314-B-195-018-MY2"],"award-info":[{"award-number":["NSC-101-2314-B-195-020, NSC103-2314-B-010-005-MY3, 103-2314-B-195-001-MY3, 101-2314-B-195-020 \u2013MY1, MOST 103-2314-B-195-006-MY3, NSC102-2314-B-002-046-MY3, 106-2314-B-195 -008-MY2, 108-2314-B-195-018-MY2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease share several cardiometabolic risk factors. Excessive visceral fat can manifest as ectopic fat depots over vital organs, such as the heart and liver. This study assessed the associations of NAFLD and liver fibrosis with cardiac structural and functional disturbances. We assessed 2161 participants using ultrasound, and categorized them as per the NAFLD Fibrosis Score into three groups: (1) non-fatty liver; (2) fatty liver with low fibrosis score; and (3) fatty liver with high fibrosis score. Epicardial fat volume (EFV) was measured through multidetector computed tomography. All participants underwent echocardiographic study, including tissue Doppler-based E\/e\u2019 ratio and speckle tracking-based left ventricular global longitudinal strain, peak atrial longitudinal strain (PALS), and atrial longitudinal strain rates during systolic, early and late-diastolic phases (ALSRsyst, ALSRearly. ALSRlate). Larger EFV, decreased e\u2019 velocity, PALS, ALSRsyst, and ALSRearly, along with elevated E\/e\u2019 ratio, were seen in all groups, especially in those with high fibrosis scores. After multivariate adjustment for traditional risk factors and EFV, fibrosis scores remained significantly associated with elevated E\/e\u2019 ratio, LA stiffness, and decreased PALS (\u03b2: 0.06, 1.4, \u22120.01, all p &lt; 0.05). Thus, NAFLD is associated with LV diastolic dysfunction and subclinical changes in LA contractile mechanics.<\/jats:p>","DOI":"10.3390\/diagnostics12040916","type":"journal-article","created":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T16:21:30Z","timestamp":1649262090000},"page":"916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Association of Non-Alcoholic Fatty Liver Disease and Hepatic Fibrosis with Epicardial Adipose Tissue Volume and Atrial Deformation Mechanics in a Large Asian Population Free from Clinical Heart Failure"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1859-6661","authenticated-orcid":false,"given":"Yau-Huei","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City 30071, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Huang","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei City 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta-Chuan","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei City 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2463-1726","authenticated-orcid":false,"given":"Chun-Ho","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"},{"name":"Department of Radiology, MacKay Memorial Hospital, Zhongshan North Road, Taipei City 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Ting","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei City 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-I","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei City 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-3493","authenticated-orcid":false,"given":"Chung-Lieh","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"},{"name":"MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Zhongshan North Road, Taipei City 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement","volume":"73","author":"Eslam","year":"2020","journal-title":"J. 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