Arriola-Montenegro J, Beas R, Cerna-Viacava R, Chaponan-Lavalle A, Hernandez Randich K, Chambergo-Michilot D, Flores Sanga H, Mutirangura P. Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease. World J Cardiol 2023; 15(7): 328-341 [PMID: 37576545 DOI: 10.4330/wjc.v15.i7.328]
Corresponding Author of This Article
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
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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.
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.
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.
