The Cardiohepatic Axis in Metabolic Disease

Heart and liver metabolic diseases often coexist because of local and systemic disorders that affect both organs via cardio-hepatic interactions. Here, we discuss the emerging evidence of organ crosstalk during cardiometabolic disease with an emphasis on the liver-to-heart axis. We highlight potential mechanisms by which metabolic dysfunction-associated steatotic liver disease contributes to cardiovascular complications. Metabolic dysfunction-associated steatotic liver disease, particularly its inflammatory entity, leads to the production of liver-derived secretory factors that regulate cardiac metabolism, inflammation, and remodeling. Thus, secreted hepatic factors represent an important mechanism of communication between the liver and heart during cardiometabolic disease. In addition to the direct crosstalk between organs, we argue that bone marrow reprogramming and clonal hematopoiesis of indeterminate potential are shared mechanisms of systemic inflammation that regulate the heart–liver axis during cardiometabolic disease. Thus, integrated cardiometabolic strategies hold a significant potential to bridge the gap between liver and cardiovascular health to improve patient outcomes.