@article{discovery10203097,
       publisher = {Ovid Technologies (Wolters Kluwer Health)},
         journal = {Circulation},
           pages = {98--119},
          volume = {151},
            note = {This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.},
           title = {Cardiovascular-Liver-Metabolic Health: Recommendations in Screening, Diagnosis, and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease in Cardiovascular Disease via Modified Delphi Approach},
            year = {2025},
          number = {1},
           month = {January},
        keywords = {atherosclerosis, cardiovascular diseases, Cardiovascular Diseases, Delphi Technique, fatty liver, Fatty Liver, Humans, isk factors, liver diseases, Mass Screening, metabolic syndrome, Metabolic Syndrome, Risk Factors},
        abstract = {There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health. Metabolic dysfunction and associated insulin resistance, together with the predilection for ectopic fat deposition in the liver and surrounding tissues, are associated with elevated risk of endothelial dysfunction, systemic inflammatory response, and ectopic fat deposition in the epicardium. This complex pathophysiology can accelerate atherogenic dyslipidemia, atherogenesis, diastolic dysfunction, valvular calcification, and cardiac arrhythmias. Despite the mounting evidence of mechanistic pathways underpinning MASLD and CVD, current recommendations have not clearly focused upon MASLD as a risk factor or target for intervention in CVD. We have brought together a diverse range of international experts committed to promoting cardiovascular-liver-metabolic health and related outcomes across the globe. The overarching goal of this document is to offer a construct for clinicians in the cardiovascular field with regards to (1) diagnosis and screening of MASLD through the use of noninvasive serum and imaging tests; (2) screening for CVD in all individuals with MASLD regardless of established atherosclerotic risk factors; and (3) the approach to management of MASLD with respect to prevention of CVD through lifestyle, as well as pharmacologic and surgical strategies. To achieve this, the modified Delphi method was applied and a series of evidence-based quality standard recommendations have been identified.},
             url = {https://doi.org/10.1161/circulationaha.124.070535},
            issn = {0009-7322},
          author = {Chew, Nicholas WS and Mehta, Anurag and Goh, Rachel Sze Jen and Zhang, Audrey and Chen, Yiming and Chong, Bryan and Chew, Han Shi Jocelyn and Shabbir, Asim and Brown, Adrian and Dimitriadis, Georgios K and Huang, Daniel Q and Foo, Roger and le Roux, Carel W and Figtree, Gemma A and Fudim, Marat and Pandey, Ambarish and Mamas, Mamas A and Hausenloy, Derek J and Richards, A Mark and Nicholls, Stephen J and Chan, Mark Y and Muthiah, Mark D and Sanyal, Arun and Sperling, Laurence S}
}