Scholarlink

Background <p>MASLD is a leading reason for liver transplant waitlisting. The relationship between cardiorespiratory fitness (CRF) and liver fibrosis in patients with MASLD remains unclear. This study aims to provide further evidence supporting the relationship between liver fibrosis and CRF.</p> Methods <p>Participants with MASLD across various fibrosis stages, including those with cirrhosis awaiting liver transplantation from three U.S. transplant centers, underwent cardiopulmonary exercise testing (CPX). We compared participants based on fibrosis stage (F0-F1, F2-F3, and F4) and CPX parameters such as VO<sub>2peak</sub>, respiratory exchange ratio (RER), ventilatory efficiency (VE/VCO<sub>2</sub>), double product (DP) and chronotropic incompetence (CI). Multivariable models were then built to evaluate factors associated with these parameters.</p> Results <p>Sixty-one participants underwent CPX testing across three centers. Participants with F4 had lower VO<sub>2peak</sub> (11.8&#xa0;mL/kg/min) compared to F0-F1 (22.2&#xa0;mL/kg/min) and F2-F3 (22.9&#xa0;mL/kg/min), <i>p</i> &lt; 0.001. Participants with F4 had higher RER (median 1.25) compared to F0-F1 (1.08) and F2-F3 (1.05), <i>p</i> = 0.001. Similarly, F4 participants exhibited higher VE/VCO<sub>2</sub> (median 36.5) compared to F0-F1 (31) and F2-F3 (30), <i>p</i> &lt; 0.001. Additionally, F4 participants had lower DP values (median 17,696) compared to F0-F1 (25,460) and F2-F3 (25,372), and higher prevalence of CI (90%) compared to F0-F1 (39%) and F2-F3 (25%), both <i>p</i> =  &lt; 0.001. Multivariable modeling confirmed advanced fibrosis (F &gt; 3) as an independent predictor of low CRF.</p> Conclusions <p>In MASLD patients, advanced liver fibrosis, particularly cirrhosis, is associated with reduced CRF and poorer hemodynamic performance during CPX. Prioritizing exercise training for those in earlier stages (F3) may prevent fitness decline, which could hinder physical training and liver transplantation candidacy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Advanced Liver Fibrosis Impairs Cardiorespiratory Fitness in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

  • 期刊论文

  • 发表日期：

    2025年2月18日

查看全文
  • Miguel Sogbe,
  • Breianna Hummer,
  • Jonathan G. Stine,
  • Blanca Lizaola-Mayo,
  • Daniel E. Forman,
  • Hugo E. Vargas,
  • Andres Duarte-Rojo

摘要

Background

MASLD is a leading reason for liver transplant waitlisting. The relationship between cardiorespiratory fitness (CRF) and liver fibrosis in patients with MASLD remains unclear. This study aims to provide further evidence supporting the relationship between liver fibrosis and CRF.

Methods

Participants with MASLD across various fibrosis stages, including those with cirrhosis awaiting liver transplantation from three U.S. transplant centers, underwent cardiopulmonary exercise testing (CPX). We compared participants based on fibrosis stage (F0-F1, F2-F3, and F4) and CPX parameters such as VO2peak, respiratory exchange ratio (RER), ventilatory efficiency (VE/VCO2), double product (DP) and chronotropic incompetence (CI). Multivariable models were then built to evaluate factors associated with these parameters.

Results

Sixty-one participants underwent CPX testing across three centers. Participants with F4 had lower VO2peak (11.8 mL/kg/min) compared to F0-F1 (22.2 mL/kg/min) and F2-F3 (22.9 mL/kg/min), p < 0.001. Participants with F4 had higher RER (median 1.25) compared to F0-F1 (1.08) and F2-F3 (1.05), p = 0.001. Similarly, F4 participants exhibited higher VE/VCO2 (median 36.5) compared to F0-F1 (31) and F2-F3 (30), p < 0.001. Additionally, F4 participants had lower DP values (median 17,696) compared to F0-F1 (25,460) and F2-F3 (25,372), and higher prevalence of CI (90%) compared to F0-F1 (39%) and F2-F3 (25%), both p =  < 0.001. Multivariable modeling confirmed advanced fibrosis (F > 3) as an independent predictor of low CRF.

Conclusions

In MASLD patients, advanced liver fibrosis, particularly cirrhosis, is associated with reduced CRF and poorer hemodynamic performance during CPX. Prioritizing exercise training for those in earlier stages (F3) may prevent fitness decline, which could hinder physical training and liver transplantation candidacy.