Coronary flow reserve is impaired in patients with nonalcoholic fatty liver disease: Association with liver fibrosis

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular disease. Coronary flow reserve (CFR) is widely used to examine the integrity of coronary microvascular circulation. We evaluated the prevalence of impaired CFR in patients with biopsy-proven NAFLD. We also investigated the independent clinical, biochemical, and liver histology predictors of CFR in the setting of NAFLD. Methods Fifty-nine consecutive patients with NAFLD and 77 age- and gender-matched controls were evaluated. CFR recordings were performed by transthoracic Doppler harmonic echocardiography. CFR ≥ 2.0 was considered normal. Results CFR was significantly lower in patients with NAFLD than in controls (2.11 ± 0.45 vs. 2.52 ± 0.62, P < 0.001). An impaired CFR (i.e.