Zhao R, Zheng JL, Wang Y, Lu BJ, Zhang Y, Deng BC. Cardio-hepatic axis in metabolic dysfunction-associated steatotic liver disease: Mechanisms, clinical implications and therapeutic opportunities. World J Hepatol 2026; 18(10): 124748 [DOI: 10.4254/wjh.124748]
Corresponding Author of This Article
Bao-Cheng Deng, Department of Infectious Diseases, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang 110001, Liaoning Province, China. bcdeng@cmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Zhao R, Zheng JL, Wang Y, Lu BJ, Zhang Y, Deng BC. Cardio-hepatic axis in metabolic dysfunction-associated steatotic liver disease: Mechanisms, clinical implications and therapeutic opportunities. World J Hepatol 2026; 18(10): 124748 [DOI: 10.4254/wjh.124748]
World J Hepatol. Oct 27, 2026; 18(10): 124748 Published online Oct 27, 2026. doi: 10.4254/wjh.124748
Cardio-hepatic axis in metabolic dysfunction-associated steatotic liver disease: Mechanisms, clinical implications and therapeutic opportunities
Ran Zhao, Jia-Lian Zheng, Yan Wang, Bing-Jiu Lu, Yan Zhang, Bao-Cheng Deng
Ran Zhao, The Second Department of Infectious Diseases, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Ran Zhao, Jia-Lian Zheng, Bing-Jiu Lu, Department of Hepatology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Yan Wang, Department of Hepatology, The Sixth People’s Hospital of Shenyang, Shenyang 110006, Liaoning Province, China
Yan Zhang, Department of Cardiology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Bao-Cheng Deng, Department of Infectious Diseases, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Co-first authors: Ran Zhao and Jia-Lian Zheng.
Co-corresponding authors: Yan Zhang and Bao-Cheng Deng.
Author contributions: Zhao R and Zheng JL contributed equally as co-first authors; Zhang Y and Deng BC contributed equally as co-corresponding authors; Zhao R drafted the original manuscript and made subsequent revisions; Zheng JL performed literature retrieval, data extraction, and systematic analysis; Wang Y participated in literature screening and data organization; Lu BJ participated in study design and supervised the project; Zhang Y formulated retrieval strategies for cardiovascular literature and revised the cardiovascular sections; Deng BC determined the topic and framework, supervised the study, and made critical revisions. All authors reviewed and approved the final manuscript.
AI contribution statement: AI tools, specifically ChatGPT-3.5, were used solely for language polishing.
Supported by National Natural Science Foundation of China, No. 82174241.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Bao-Cheng Deng, Department of Infectious Diseases, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang 110001, Liaoning Province, China. bcdeng@cmu.edu.cn
Received: June 29, 2026 Revised: August 4, 2026 Accepted: September 17, 2026 Published online: October 27, 2026 Processing time: 119 Days and 18.1 Hours
Core Tip
Core Tip: Metabolic dysfunction-associated steatotic liver disease is a systemic cardiometabolic disorder driven by the cardio-hepatic axis. This review examines bidirectional signaling and systemic amplification networks within this axis and explores its intrinsic mechanisms. Based on population evidence, we propose a risk stratification framework that integrates metabolic dysfunction-associated steatotic liver disease evaluation into cardiovascular risk assessment, shifting management from a liver-centric to a systemic cardio-hepatic co-management model. We also critically appraise therapeutic strategies targeting these mechanisms according to clinical evidence strength. However, key challenges remain, including the liver-heart causal relationship, the lack of a risk assessment system capturing cardio-hepatic crosstalk, and the limited availability of axis-specific randomized controlled trials.
