{
  "abstract": "Background The nomenclature change from non-alcoholic fatty liver disease to metabolic dysfunction-associated steatotic liver disease (MASLD) better encapsulates the associated metabolic milieu. While MASLD is associated with increased heart failure (HF) risk, characteristics and outcomes of MASLD in patients with HF remain unclear. This paper aims to examine the prevalence and clinical correlates of MASLD in patients with HF from the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) Registry. Methods MASLD was defined as evidence of hepatic steatosis, with at least one of five metabolic criteria (among body mass index, glucose, blood pressure, triglycerides and high-density lipoprotein thresholds). Findings were externally validated in Clinical Data Analysis and Reporting System (CDARS), a Hong Kong HF cohort and BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF), a HF cohort across 11 European countries. Results Of 2698 patients with HF in ASIAN-HF, 927 (34.4%) had MASLD. They were younger, more often women and more likely to have HF with preserved ejection fraction (HFpEF) compared with those without MASLD. All-cause mortality was lower in MASLD versus non-MASLD (7.1% vs 11.7%, p=0.001), even after multivariable adjustment (adjusted HR (aHR) 0.58, 95% CI 0.39 to 0.86, p=0.007). Allcause mortality was also lower in MASLD versus non-MASLD in CDARS and BIOSTAT-CHF; however, after multivariable adjustment, the association remained significant only in CDARS (aHR 0.82, 95% CI 0.80 to 0.84, p<0.001) and was attenuated in BIOSTAT-CHF (aHR 1.08, 95% CI 0.67 to 1.73, p=0.750). Using waist-to-height ratio instead of body mass index in the MASLD definition reclassified <3% of patients. Conclusions In patients with HF, MASLD is highly prevalent, especially in younger women with HFpEF and is associated with better 1-year survival than in those without MASLD.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, National University Heart Centre, National University Hospital, Singapore.",
    "Duke-NUS Medical School, Singapore.",
    "National Heart Centre, Singapore.",
    "University of Amsterdam, Amsterdam, The Netherlands.",
    "Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong.",
    "Institute of Cardiovascular Sciences and Medicine, Hong Kong, Hong Kong.",
    "Yong Loo Lin School of Medicine, National University of Singapore, Singapore.",
    "Saw Swee Hock School of Public Health, National University of Singapore, Singapore.",
    "Department of Cardiovascular Medicine, University of Minnesota, Minneapolis, Minnesota, USA.",
    "Heart Failure Program, VA Medical Center, Minneapolis, Minnesota, USA.",
    "Christchurch Heart Institute, University of Otago, Dunedin, Otago, New Zealand.",
    "Cardiovascular Research Institute, National University Heart Centre, Singapore.",
    "Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore.",
    "National University Centre for Organ Transplantation, National University Health System, Singapore.",
    "Université de Lorraine and CHRU, Nancy, France.",
    "Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.",
    "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.",
    "Division of Cardiology, Department of Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China.",
    "University of Groningen, Groningen, The Netherlands.",
    "Duke-NUS Medical School, Singapore carolyn.lam@duke-nus.edu.sg."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nicholas Ws Chew",
      "orcid": "0000-0002-0640-0430"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Chandramouli Chanchal"
    },
    {
      "affs": [
        2
      ],
      "name": "Wan Ting Tay"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Wouter Ouwerkerk"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Qingwen Ren"
    },
    {
      "affs": [
        2
      ],
      "name": "Tiew-Hwa Katherine Teng"
    },
    {
      "affs": [
        6
      ],
      "name": "Yiming Chen"
    },
    {
      "affs": [
        6
      ],
      "name": "Bryan Chong"
    },
    {
      "affs": [
        0
      ],
      "name": "Haryo Teguh Raden Himan"
    },
    {
      "affs": [
        1,
        6,
        7
      ],
      "name": "Jasper Tromp"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Inder S Anand"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Arthur Mark Richards"
    },
    {
      "affs": [
        12,
        13
      ],
      "name": "Mark Dhinesh Muthiah",
      "orcid": "0000-0002-9724-4743"
    },
    {
      "affs": [
        14
      ],
      "name": "Faiez Zannad"
    },
    {
      "affs": [
        15
      ],
      "name": "Muthiah Vaduganathan"
    },
    {
      "affs": [
        16
      ],
      "name": "Naveed Sattar"
    },
    {
      "affs": [
        4,
        5,
        17
      ],
      "name": "Kai Hang Yiu",
      "orcid": "0000-0003-2145-3108"
    },
    {
      "affs": [
        18
      ],
      "name": "Adriaan A Voors"
    },
    {
      "affs": [
        19,
        2
      ],
      "name": "Carolyn S P Lam",
      "orcid": "0000-0003-1903-0018"
    },
    {
      "name": "ASIAN-HF Investigators"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/71gyj6r7xp8at.bib",
  "cited_by": 0,
  "doi": "10.1136/openhrt-2026-004357",
  "fulltext_url": "https://europepmc.org/articles/PMC13691740",
  "id": "71gyj6r7xp8at",
  "issns": [
    "2053-3624"
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  "landing_url": "https://europepmc.org/article/MED/42906951",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
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  "pdf_url": "https://europepmc.org/articles/PMC13691740?pdf=render",
  "pmcid": "PMC13691740",
  "pmid": "42906951",
  "published": "2026-10-21",
  "publisher": "British Cardiovascular Society",
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      "origin": "openalex:2713|Liver Disease Diagnosis and Treatment",
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  "title": "Prevalence and clinical correlates of metabolic dysfunction-associated steatotic liver disease in heart failure.",
  "title_text": "Prevalence and clinical correlates of metabolic dysfunction-associated steatotic liver disease in heart failure.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:12Z",
  "url": "https://research.draconitic.com/paper/71gyj6r7xp8at",
  "venue": "Open heart",
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