Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2024; 16(11): 660-664
Published online Nov 26, 2024. doi: 10.4330/wjc.v16.i11.660
Kill two birds with one stone: Hapatologist’s approach to metabolic dysfunction-associated steatotic liver disease and heart failure
Yusuke Hirao, Clarke Morihara, Tomoki Sempokuya
Yusuke Hirao, Clarke Morihara, Department of Medicine, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, United States
Tomoki Sempokuya, Division of Gastroenterology and Hepatology, Department of Medicine, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, United States
Author contributions: Hirao Y, Clarke M, and Sempokuya T contributed to the literature review, manuscript drafting, and editing; Sempokuya T contributed to article supervision; all of the authors have approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tomoki Sempokuya, MD, Assistant Professor, Division of Gastroenterology and Hepatology, Department of Medicine, John A Burns School of Medicine, University of Hawaii at Manoa, 550 S Beretania Street, No. 501, Honolulu, HI 96813, United States. tsempoku@hawaii.edu
Received: May 11, 2024
Revised: September 25, 2024
Accepted: October 21, 2024
Published online: November 26, 2024
Processing time: 172 Days and 23.9 Hours
Abstract

Heart failure (HF) is a major global public health concern, and one of the less commonly known risk factors for HF development is metabolic dysfunction-associated steatotic liver disease (MASLD), as they share a similar pathophysiological background. In this article, we evaluated a recently published review article by Arriola-Montenegro et al. This article briefly summarizes the common pathophysiology of HF and MASLD development and evaluates the available therapeutic options to treat both conditions. Clinical practice guidelines highlight the importance of initiating and titrating guideline-directed medication therapy (GDMT) for patients with HF with reduced ejection fraction. GDMT is comprised of the four pillars currently proposed in most clinical practice guidelines, namely angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter 2 inhibitors (SGLT-2i). Given the similarity of pathophysiology and risk factors, recent studies for GDMT regarding ACEIs, ARBs, mineralocorticoid receptor antagonists, and SGLT-2i have shown beneficial effects on MASLD. Nonetheless, other medications for both conditions and novel therapies require more robust data and well-designed clinical studies to demonstrate their efficacies in both conditions.

Keywords: Metabolic dysfunction-associated steatotic liver disease; Heart failure; Heart failure with reduced ejection fraction; Non-pharmacological; Pharmacological; Surgical intervention

Core Tip: Due to common risk factors and underlying pathophysiologic mechanisms, there is a significant association between heart failure with reduced ejection fraction and metabolic dysfunction-associated steatotic liver disease. This article will explore the current pharmacological and non-pharmacological interventions.