Journal Article Ppublish
PubMed: 40335668 DOI: 10.1038/s41591-025-03654-2
Cardiac and liver impairment on multiorgan MRI and risk of major adverse cardiovascular and liver events.
Nat Med 31(7):2289-2296
Authors: Edward Jackson, Andrea Dennis, Naim Alkhouri, Niharika Samala, Raj Vuppalanchi, Arun J Sanyal, Mark Muthiah, Rajarshi Banerjee, Amitava Banerjee
Affiliations
- Perspectum Ltd, Oxford, UK.
- Arizona Liver Health, Phoenix, AZ, USA.
- Summit Clinical Research, San Antonio, AZ, USA.
- Indiana University School of Medicine, Bloomington, IN, USA.
- Virginia Commonwealth University, Richmond, VA, USA.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
- Oxford University Hospitals NHS Trust, Oxford, UK.
- University College London, London, UK.
Abstract
Cardiovascular disease and metabolic dysfunction-associated steatotic liver disease are common conditions associated with high mortality and morbidity, yet opportunities for integrated prevention are underinvestigated. We explored the association between impairment in the liver (defined by increased iron-corrected T1 (cT1) time) and/or heart (reduced left ventricular ejection fraction ≤ 50) and risk of experiencing cardiovascular- or liver-related events or all-cause mortality among 28,841 UK Biobank participants who underwent magnetic resonance imaging. Using Cox proportional hazard models, adjusted for age, sex, body mass index, type 2 diabetes and dyslipidaemia, we observed that cardiac impairment was associated with increased incidence of cardiovascular events (hazard ratio (HR) 2.3 (1.9-2.7)) and hospitalization (HR 2.1 (1.8-2.4)). Liver impairment was associated with incident cardiovascular hospitalization (cT1 ≥ 800 ms, HR 1.3 (1.1-1.5)), liver events (cT1 ≥ 875 ms, HR 9.2 (3.2-26) and hospitalization (cT1 ≥ 875 ms, HR 5.5 (3.2-9.3). Associations between cT1 and liver events were maintained in participants with metabolic dysfunction-associated steatotic liver disease (N = 6,223). Reduced left ventricular ejection fraction (≤50) combined with elevated cT1 (≥800 ms) were associated with earlier cardiovascular events (time to event 0.8 versus 2.4 years; P < 0.05). Cardiac and liver impairment are independently, or in combination, associated with cardiovascular or liver events, suggesting a dual role for magnetic resonance imaging in integrated prevention pathways.
MeSH
Liver Diseases, Mortality, Hospitalization, Magnetic Resonance Imaging, Liver