Heart failure with preserved ejection fraction and metabolic dysfunction-associated steatotic liver disease: Twin challenges, one metabolic solution

Heart failure (HF) with preserved ejection fraction (HFpEF) has exceeded HF with reduced ejection fraction (HFrEF), becoming the most common type of HF. Unlike HFrEF, HFpEF is primarily a chronic low-grade inflammatory process closely associated with metabolic disorders. The coexistence of HFpEF and metabolic dysfunction-associated steatotic liver disease (MASLD) presents significant clinical challenges due to shared metabolic pathophysiology and complex interplay. Management strategies for HFpEF and MASLD remain challenging. Sodium-glucose cotransporter 2 inhibitors have shown benefits in managing both conditions. Additionally, glucagon-like peptide-1 receptor agonists are being actively investigated for their potential benefits, particularly in MASLD. A comprehensive, patient-centered approach that combines metabolic and cardiovascular care is essential for improving outcomes in patients with HFpEF and MASLD, addressing the global metabolic health challenges.