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

Authors Karn Wijarnpreecha, Panadeekarn Panjawatanan, Paul T. Kroner, Wisit Cheungpasitporn, Patompong Ungprasert.


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; I2 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, nonalcoholic steatohepatitis, heart block, cardiac conduction defect, meta-analysis

Ann Gastroenterol 2020; 33 (6): 661-666

Original Articles