FIB-4 liver fibrosis index correlates with aortic valve sclerosis in non-alcoholic population

DURAK H., ÇETİN M., EMLEK N., ERGÜL E., ÖZYILDIZ A. G., Öztürk M., ...More

Echocardiography, vol.41, no.1, 2024 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 41 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.1111/echo.15732
  • Journal Name: Echocardiography
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Keywords: aortic valve sclerosis, FIB-4 index, liver fibrosis, non-alcoholic fatty liver disease
  • Recep Tayyip Erdoğan University Affiliated: Yes


Aim: Hepatic fibrosis, a progressive scarring of liver tissue, is commonly caused by non-alcoholic fatty liver disease (NAFLD), which increases the risk of cardiovascular disease. The Fibrosis-4 (FIB-4) index is a non-invasive tool used to assess liver fibrosis in patients with NAFLD. Aortic valve sclerosis (AVS), a degenerative disorder characterized by thickening and calcification of valve leaflets, is prevalent in the elderly and associated with increased cardiovascular morbidity and mortality. Recent studies have suggested that AVS may also be linked to other systemic diseases such as liver fibrosis. This study aimed to investigate the relationship between the FIB-4 index and AVS in a non-alcoholic population, with the hypothesis that the FIB-4 index could serve as a potential marker for AVS. Method: A total of 92 patients were included in this study. AVS was detected using transthoracic echocardiography, and patients were divided into groups according to the presence of AVS. The FIB-4 index was calculated for all patients and compared between the groups. Results: A total of 17 (18.4%) patients were diagnosed AVS. Patients with AVS had higher rates of diabetes mellitus, older age, hypertension, angiotensin-converting enzyme inhibitor use, higher systolic blood pressure (BP) and diastolic BP in the office, coronary artery disease prevalence, left atrial volume index (LAVI), left ventricular mass index (LVMI), and late diastolic peak flow velocity (A) compared to those without AVS. Moreover, AVS patients had significantly higher creatinine levels and lower estimated glomerular filtration rate. Remarkably, the FIB-4 index was significantly higher in patients with AVS. In univariate and multivariate analyses, higher systolic BP in the office (OR, 1.044; 95% CI 1.002–1.080, p =.024) and higher FIB-4 index (1.46 ±.6 vs.91 ±.46, p <.001) were independently associated with AVS. Conclusion: Our findings suggest that the FIB-4 index is associated with AVS in non-alcoholic individuals. Our results highlight the potential utility of the FIB-4 index as a non-invasive tool for identifying individuals at an increased risk of developing AVS.