Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 18, 2017; 9(2): 69-73
Published online Jan 18, 2017. doi: 10.4254/wjh.v9.i2.69
From the liver to the heart: Cardiac dysfunction in obese children with non-alcoholic fatty liver disease
Anna Di Sessa, Giuseppina Rosaria Umano, Emanuele Miraglia del Giudice, Nicola Santoro
Anna Di Sessa, Giuseppina Rosaria Umano, Emanuele Miraglia del Giudice, Department of Woman and Child and General and Specialized Surgery, Seconda Università degli Studi di Napoli, 80138 Naples, Italy
Anna Di Sessa, Nicola Santoro, Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, United States
Author contributions: All the authors conceived and wrote the manuscript.
Supported by The Allen Foundation, the American Heart Association (AHA), No. 13SDG14640038; and the American Heart Association (AHA) to Dr Nicola Santoro, No. 16IRG27390002.
Conflict-of-interest statement: Nothing to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nicola Santoro, MD, PhD, Department of Pediatrics, Yale University School of Medicine, 330 Cedar Street, PO Box 208064, New Haven, CT 06520, United States. nicola.santoro@yale.edu
Telephone: +1-203-7376356 Fax: +1-203-7856421
Received: August 22, 2016
Peer-review started: August 24, 2016
First decision: September 27, 2016
Revised: October 24, 2016
Accepted: November 21, 2016
Article in press: November 22, 2016
Published online: January 18, 2017

In the last decades the prevalence of non-alcoholic fatty liver disease (NAFLD) has increased as a consequence of the childhood obesity world epidemic. The liver damage occurring in NAFLD ranges from simple steatosis to steatohepatitis, fibrosis and cirrhosis. Recent findings reported that fatty liver disease is related to early atherosclerosis and cardiac dysfunction even in the pediatric population. Moreover, some authors have shown an association between liver steatosis and cardiac abnormalities, including rise in left ventricular mass, systolic and diastolic dysfunction and epicardial adipose tissue thickness. In this editorial, we provide a brief overview of the current knowledge concerning the association between NAFLD and cardiac dysfunction.

Keywords: Cardiac dysfunction, Non-alcoholic fatty liver disease atherosclerosis, Children, Cardiovascular risk

Core tip: Recently, growing scientific evidences suggest that obese children with non-alcoholic fatty liver disease are more predisposed to cardiovascular disease. Interestingly, this association seems to be independent from adiposity. In fact, based on recent findings, it has been proposed that liver steatosis plays an independent role in determining early atherosclerosis and cardiac dysfunction.