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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2023; 15(7): 328-341
Published online Jul 26, 2023. doi: 10.4330/wjc.v15.i7.328
Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease
Jose Arriola-Montenegro, Renato Beas, Renato Cerna-Viacava, Andres Chaponan-Lavalle, Karla Hernandez Randich, Diego Chambergo-Michilot, Herson Flores Sanga, Pornthira Mutirangura
Jose Arriola-Montenegro, Department of Internal Medicine, University of Minnesota, Minneapolis, MN 55455, United States
Renato Beas, Department of Medicine, Indiana University School of Medicine, Indiana, IN 46202, United States
Renato Cerna-Viacava, Department of Medicine, Henry Ford Hospital, Detroit, MI 48202, United States
Andres Chaponan-Lavalle, Karla Hernandez Randich, Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru
Diego Chambergo-Michilot, Universidad Científica del Sur, Lima, Peru
Herson Flores Sanga, Department of Telemedicine, Cardiology, Hospital Nacional Carlos Alberto Seguin Escobedo, Arequipa 8610, Peru
Pornthira Mutirangura, Department of Medicine, University of Minnesota, Minneapolis, MN 55415, United States
Author contributions: All authors contributed to the design and implementation of the research and to the writing 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: Jose Arriola-Montenegro, MD, Department of Internal Medicine, University of Minnesota, 401 East River Parkway VCRC 1st Floor, Suite 131, Minneapolis, MN 55455, United States. jose.arriola26@gmail.com
Received: May 4, 2023
Peer-review started: May 4, 2023
First decision: June 1, 2023
Revised: June 9, 2023
Accepted: June 21, 2023
Article in press: June 21, 2023
Published online: July 26, 2023
Processing time: 82 Days and 6.5 Hours
Abstract

Heart failure with reduced ejection fraction (HFrEF) and nonalcoholic fatty liver disease (NAFLD) are two common comorbidities that share similar pathophysiological mechanisms. There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD. This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD. Pharmacological therapies, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoids receptor antagonist, and sodium-glucose cotransporter-2 inhibitors, have been shown to reduce fibrosis and fat deposits in the liver. However, there are currently no data showing the beneficial effects of sacubitril/valsartan, ivabradine, hydralazine, isosorbide nitrates, digoxin, or beta blockers on NAFLD in patients with HFrEF. This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities. Further research is needed in patients with coexisting HFrEF and NAFLD, with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities.

Keywords: Non-alcoholic fatty liver disease; Heart Failure; Heart failure reduced ejection fraction; Novel therapies; Cardiovascular disease

Core Tip: This manuscript provides an overview of potential therapies for patients with coexisting heart failure with reduced ejection fraction and nonalcoholic fatty liver disease (NAFLD). The authors discuss the current research of pathogenesis in heart failure and NAFLD, as well as pharmacological therapies that have been shown benefits. We also discuss the potential role of diet, physical activity and novel therapies in managing these conditions.