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REVIEW article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1573841
Cross-talk between the heart and the liver: a A bidirectional relationship ofbetween fatty liver and cardiac inflammatory diseasesMetabolic dysfunction-associated fatty liver disease is associated with atrial fibrillation and heart failure: molecular and clinical aspects
Provisionally accepted
Jamie Cheung 1*
Bernard Man Yung Cheung 1
Kai Hang Yiu 1,2,3
Hung Fat Tse 1,2
Yap Hang Chan 1,3,4,5*- 1 Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
- 2 Department of Medicine, Shenzhen Hong Kong University Hospital, Shenzhen, China
- 3 Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
- 4 Division of Experimental Medicine and Immunotherapeutics, Cambridge University Hospitals NHS Foundation Trust / University of Cambridge, Cambridge, United Kingdom
- 5 Department of Cardiology, Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom
Metabolic dysfunction-associated fatty liver disease (MASLD) is a rising global health concern. In addition to direct hepatic complications, extra-hepatic complications, including cardiovascular diseases (CVD), type 2 diabetes (T2D), gastroesophageal reflux disease, chronic kidney disease and some malignancies, are increasingly recognized. CVD, including atrial fibrillation (AF) and heart failure (HF), Cardiovascular complicationis s are the leading cause of death in patients with MASLD. External factors, including excess energy intake, sedentary lifestyle and xenobiotic use, induce inflammation and inflammation-related complications. MASLD, AF, and HF are associated with immune system activation, including the reprogramming of immune cells and the establishment of immune memory. Emerging evidence suggests that the heart and the liver cross-talk with each other through the diverse spectrum of autocrine, paracrine and endocrine mechanisms. Pro-inflammatory cytokines produced from the liver and the heart circulate systemically to orchestrate metabolic derangements that promote the development of end-organ complicationssystematic immune dysregulation in the heart-liver axis and the development of end-organ complications.. Cardio-hepatic syndrome describes the clinical and biochemical evidences of hepatic dysfunction and cardiac pathology due to the interaction between the heart and the liver. Activation of inflammatory cascades, and oxidative stress and immune system dysregulation underlie two key mechanisms in bringing about such pathological changes.In tThis review, we focu focuses on the current clinical and molecular evidences pertaining toabout the cross-talks between the heart and the liver, heart-liver cross-talkand. It summarizes the epidemiological and pathophysiological associations of MASLD, AF and HF. atrial fibrillation (AF), and heart failure (HF). In addition, we will discuss how repurposing the currently available and emerging pharmacotherapies may potentially help to tackle the cardiovascular risks resulting from MASLD.
Keywords: MASLD, AF, hf, Cross-talk, Adipokines, Hepatokines, Interleukins, Cytokines
Received: 10 Feb 2025; Accepted: 24 Mar 2025.
Copyright: © 2025 Cheung, Cheung, Yiu, Tse and Chan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jamie Cheung, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
Yap Hang Chan, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
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