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Updated: Nov 25, 2025
Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
Published on: March 29, 2024
Part 1: Disease of the Heart and Liver: A Relationship That Cuts Both Ways
Nicholas Scalzo1, Mehtap Canastar, Edward Lebovics
1From the Department of Medicine, Section of Gastroenterology & Hepatobiliary Diseases, New York Medical College and Westchester Medical Center, Valhalla, NY.
Insights
The heart and liver have complex interactions. Heart failure impacts the liver, while liver disease, like cirrhosis, affects the heart, influencing treatment and transplantation risks.
Area of Science:
- Cardiology
- Hepatology
- Organ Interaction
Background:
- The heart and liver exhibit intricate, bidirectional communication.
- Liver disease can cause cardiac dysfunction, and heart failure can lead to hepatic injury.
- Nonalcoholic fatty liver disease is linked to increased cardiovascular mortality.
Purpose of the Study:
- To review the cardiac effects of liver disease and hepatic effects of heart disease.
- To highlight how co-existing heart and liver conditions complicate management and increase transplantation risks.
Main Methods:
- Literature review focusing on cardiac and hepatic interactions.
- Analysis of disease mechanisms and clinical implications.
- Discussion of management strategies in dual-organ involvement.
Main Results:
- Acute and chronic heart failure can cause acute cardiogenic liver injury and congestive hepatopathy.
- Cirrhosis can result in cirrhotic cardiomyopathy, including systolic/diastolic dysfunction and electrophysiological disturbances.
- Management of either organ disease is altered by the presence of the other.
Conclusions:
- Understanding the heart-liver axis is crucial for effective patient management.
- Dual-organ involvement significantly increases risks for interventions like transplantation.
- Expanding knowledge of heart-liver communication improves therapeutic approaches.
Abstract:
The heart and the liver display multifaceted, complex interactions that can be divided into cardiac effects of liver disease, hepatic effects of heart disease, and disease processes affecting both organs. In part 1 of this 2 part series, we discuss how acute and chronic heart failure can have devastating effects on the liver, such as acute cardiogenic liver injury and congestive hepatopathy. On the other hand, primary liver disease, such as cirrhosis, can lead to a plethora of cardiac insults representative in cirrhotic cardiomyopathy as systolic dysfunction, diastolic dysfunction, and electrophysiological disturbances. Nonalcoholic fatty liver disease has long been associated with cardiovascular events that increase mortality. The management of both disease processes changes when the other organ system becomes involved. This consideration is important with regard to a variety of interventions, most notably transplantation of either organ, as risk of complications dramatically rises in the setting of both heart and liver disease (discussed in part 2). As our understanding of the intricate communication between the heart and liver continues to expand so does our management.
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