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Publications

Journal Article Review Epublish

PubMed: 40721859 DOI: 10.1038/s43856-025-00951-2

Guideline-directed medical strategies for the co-management of heart failure and metabolic dysfunction-associated steatotic liver disease.

Commun Med (Lond) 5(1):312

Authors: Jacob J Gries, Bing Chen, Meena B Bansal, Mario Rodriguez, Saleh A Alqahtani, Paul N Brennan, Chim C Lang, W H Wilson Tang, Jeffrey V Lazarus, Chayakrit Krittanawong

Affiliations

  • Department of Internal Medicine, Geisinger Medical Center, Danville, PA, USA.
  • Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, PA, USA.
  • Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Division of Cardiovascular disease, John T Milliken Department of Medicine, Section of Advanced Heart Failure and Transplant, Barnes-Jewish Hospital/Washington University in St.Louis School of Medicine, St. Louis, MO, USA.
  • Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK.
  • Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
  • CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA.
  • Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
  • HumanX, Delaware, DE, USA.

Abstract

There is a high and rising global prevalence of people with both metabolic dysfunction-associated steatotic liver disease (MASLD) and heart failure, which has a severe impact, highlighting the need to address these conditions. However, the relationship between MASLD and heart failure remains underexplored. This comprehensive narrative review explores the shared pathophysiological mechanisms, diagnostic evaluations, and current medical and surgical recommendations for heart failure therapy in the context of co-existing MASLD. Here, we show the need for co-management of MASLD and the different subtypes of heart failure, integrating both standard and innovative heart failure treatments with those targeting MASLD. We highlight the benefits of certain drug classes and surgical interventions for both conditions while noting potential adverse outcomes with others. To address the global rise in metabolic diseases, a holistic, coordinated, and multidisciplinary approach is essential. Collaborative efforts between cardiologists and hepatologists are crucial for developing tailored interventional strategies to prevent and manage comorbid conditions, thereby mitigating the threats posed by MASLD and heart failure.

MeSH

Liver Diseases, Heart Failure, Heart, Liver, Therapeutics