Association between metabolic dysfunction-associated steatotic liver disease and heart failure with preserved ejection fraction.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly associated with heart failure with preserved ejection fraction (HFpEF), driven by systemic inflammation, insulin resistance, and oxidative stress, which are shared pathophysiological mechanisms. HFpEF and MASLD often co-occur, especially in patients with conditions like obesity and type 2 diabetes mellitus (T2DM). The increasing global prevalence of both MASLD and HFpEF emphasises their shared risk factors and clinical implications. Early diagnosis and a multidisciplinary approach are important in the management of these interconnected diseases. Treatment strategies like the use of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) have shown promise in addressing both conditions, improving liver steatosis, and reducing heart failure risk. Targeted therapies and lifestyle modifications are fundamental to managing MASLD and HFpEF, given their overlapping pathophysiology and impact on patient outcomes.