Risk of heart failure in patients with non-alcoholic fatty liver disease. JACC Review Topic of the Week.

Heart failure (HF) and nonalcoholic fatty liver disease (NAFLD) are 2 conditions that have become important global public health problems. Emerging evidence supports a strong and independent association between NAFLD and the risk of new-onset HF, and there are multiple potential pathophysiological mechanisms by which NAFLD may increase risk of new-onset HF. The magnitude of this risk parallels the underlying severity of NAFLD, especially the level of liver fibrosis. Patients with NAFLD develop accelerated coronary atherosclerosis, myocardial alterations (mainly cardiac remodeling and hypertrophy), and certain arrhythmias (mainly atrial fibrillation), which may precede and promote the development of new-onset HF. This brief narrative review aims to provide an overview of the association between NAFLD and increased risk of new-onset HF, discuss the underlying mechanisms that link these 2 diseases, and summarize targeted pharmacological treatments for NAFLD that might also reduce the risk of HF.

NAFLD, NASH, SGLT2-inhibitors, heart failure, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis

10.1016/j.jacc.2021.11.007

0735-1097

180-191

Mantovani, Alessandro

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Byrne, Christopher

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Benfari, Giovanni

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Bonapace, Stefano

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Simon, Tracey G.

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Targher, Giovanni

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18 January 2022

Mantovani, Alessandro

c09475f7-df6b-4491-81cd-d074c04913d9

Byrne, Christopher

1370b997-cead-4229-83a7-53301ed2a43c

Benfari, Giovanni

59a39ca7-af83-4414-a8ae-7cec5ebbdb97

Bonapace, Stefano

fc69d855-ab7c-4b28-9bfa-ee49142ccffb

Simon, Tracey G.

d24752f9-94d1-4257-9008-55a5a445fd0b

Targher, Giovanni

6ccf6557-5141-43d0-8867-0b1326343209

Mantovani, Alessandro, Byrne, Christopher, Benfari, Giovanni, Bonapace, Stefano, Simon, Tracey G. and Targher, Giovanni (2022) Risk of heart failure in patients with non-alcoholic fatty liver disease. JACC Review Topic of the Week. Journal of the American College of Cardiology, 79 (2), 180-191. (doi:10.1016/j.jacc.2021.11.007).

Record type: Article

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Accepted/In Press date: 2 November 2021

e-pub ahead of print date: 10 January 2022

Published date: 18 January 2022

Additional Information: Funding Information: Dr Byrne has been supported in part by the Southampton NIHR Biomedical Research Centre (IS-BRC-20004), United Kingdom. Dr Simon has been supported by grants from the National Institutes of Health (K23-DK122104) and the Dana-Farber/Harvard Cancer Center. Dr Targher has been supported in part by grants from the School of Medicine, University of Verona, Verona, Italy. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: © 2022 American College of Cardiology Foundation Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

Keywords: NAFLD, NASH, SGLT2-inhibitors, heart failure, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis