Current Heart Failure Reports · 3 authors, 2 centres
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This narrative review summarizes observational cohort studies showing that NAFLD is significantly associated with increased long-term risk of new-onset heart failure, even after adjustment for common cardiometabolic risk factors. The risk is further elevated with more advanced liver fibrosis, though no cause-and-effect relationship has been proven.
This narrative review synthesizes evidence from observational cohort studies examining the association between non-alcoholic fatty liver disease (NAFLD) and new-onset heart failure (HF). The authors report that recent observational cohort studies support a significant association between NAFLD and long-term risk of incident HF, with the risk remaining statistically significant after adjustment for age, sex, ethnicity, adiposity measures, type 2 diabetes, and other cardiometabolic risk factors. The risk of incident HF was further increased with more advanced liver disease, especially higher severity of liver fibrosis. The review discusses multiple potential pathophysiological mechanisms by which NAFLD may increase HF risk, including effects on cardiac function and structure. The authors note that no studies to date have proven a cause-and-effect relationship. The review also summarizes targeted pharmacotherapies for NAFLD, including GLP-1 receptor agonists and SGLT-2 inhibitors, that may also beneficially affect cardiac complications.
