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The Cardiohepatic Axis in Heart Failure

Arick C Park1, Joel D Schilling2

  • 1Department of Internal Medicine, Washington University School of Medicine in St Louis, St. Louis, Missouri, USA.

JACC. Basic to Translational Science
|July 30, 2025
PubMed

Insights

Cardiogenic liver disease, a consequence of heart failure, causes liver dysfunction. Further research is needed to understand the underlying mechanisms of liver fibrosis and dysfunction in heart failure patients.

Area of Science:

  • Cardiology
  • Hepatology
  • Pathology

Background:

  • Cardiogenic liver disease results from hepatic congestion due to right heart failure.
  • It leads to hepatic dysfunction and liver remodeling.
  • Understanding liver pathology in heart failure is crucial for patient care.

Purpose of the Study:

  • To review current understanding of the cardiohepatic axis in heart failure.
  • To highlight knowledge gaps in cardiogenic liver disease.
  • To identify opportunities for future research.

Main Methods:

  • Review of recent human and preclinical data.
  • Analysis of cellular and molecular pathways involved in cardiogenic liver disease.

Main Results:

  • Liver congestion triggers significant responses in hepatocytes and nonparenchymal cells.
  • Pathways driving liver fibrosis and dysfunction remain poorly understood.
  • Emerging data is beginning to elucidate the cellular and molecular landscape.

Conclusions:

  • Cardiogenic liver disease is a complex condition requiring further investigation.
  • Elucidating the mechanisms of liver fibrosis and dysfunction is essential.
  • Future research should focus on the cardiohepatic axis to improve patient outcomes.

Keywords:
biliary metaplasiaheart failureliver fibrosismacrophagestellate cells

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