Cardiohepatic Interactions in Heart Failure Management
Summary
Heart failure induces hepatic congestion and hypoperfusion, leading to a spectrum of liver abnormalities collectively termed congestive hepatopathy. Elevated central venous pressure impairs sinusoidal blood flow, while reduced cardiac output compromises hepatic perfusion. These derangements trigger inflammation, oxidative stress and fibrotic remodelling in the liver, which in turn release metabolic mediators that may exacerbate cardiac dysfunction. Emerging evidence highlights the role of hepatokines in modulating systemic metabolism and organ cross-talk. Quantitative assessment of liver function using biochemical scores and imaging biomarkers has become integral to risk stratification in heart failure. Therapeutic approaches that relieve venous congestion, optimise forward flow and target inter-organ signalling pathways hold promise for improving outcomes. Given the global burden of heart failure and its associated hepatic complications, a multidisciplinary strategy is required to integrate hepatological assessment into routine cardiac care.
Research from Nature Portfolio
Recent studies have demonstrated that serum γ-glutamyltransferase independently predicts adverse events in heart failure with preserved ejection fraction. Higher γ-glutamyltransferase levels correlate with both left- and right-sided haemodynamic alterations and are linked to increased hospitalisation and mortality. Echocardiographic measures of atrial pressure and chamber dimensions show a graded association with this enzyme, suggesting that simple liver function tests can enhance risk stratification when advanced diagnostic modalities are not available.
Cardiohepatic Interactions in Heart Failure Management publication trend
The graph below shows the total number of articles in cardiohepatic interactions in heart failure management across all publications each year (not limited to Nature Index journals).
Technical terms
Congestive hepatopathy: Hepatic injury resulting from elevated venous pressure and reduced perfusion in heart failure.
Hepatokines: Bioactive proteins secreted by hepatocytes that regulate systemic metabolism and inter-organ signalling.
MELD-XI score: A prognostic index of liver dysfunction calculated from serum bilirubin and creatinine, excluding coagulation parameters.
Albumin–bilirubin (ALBI) score: A quantitative assessment of hepatic reserve based on albumin and bilirubin concentrations.
Cholestasis: Impairment of bile formation or flow, reflected by elevations in alkaline phosphatase and bilirubin.
References
- Cardiac Hepatopathy: New Perspectives on Old Problems through a Prism of Endogenous Metabolic Regulations by Hepatokines. Antioxidants (2023).
- Liver tests and outcomes in heart failure with reduced ejection fraction: findings from DAPA‐HF. European Journal of Heart Failure (2022).
- Serum levels of gamma-glutamyltransferase predict outcome in heart failure with preserved ejection fraction. Scientific Reports (2019).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.