eprintid: 10203097 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/20/30/97 datestamp: 2025-01-08 12:20:51 lastmod: 2025-01-08 12:20:51 status_changed: 2025-01-08 12:20:51 type: article metadata_visibility: show sword_depositor: 699 creators_name: Chew, Nicholas WS creators_name: Mehta, Anurag creators_name: Goh, Rachel Sze Jen creators_name: Zhang, Audrey creators_name: Chen, Yiming creators_name: Chong, Bryan creators_name: Chew, Han Shi Jocelyn creators_name: Shabbir, Asim creators_name: Brown, Adrian creators_name: Dimitriadis, Georgios K creators_name: Huang, Daniel Q creators_name: Foo, Roger creators_name: le Roux, Carel W creators_name: Figtree, Gemma A creators_name: Fudim, Marat creators_name: Pandey, Ambarish creators_name: Mamas, Mamas A creators_name: Hausenloy, Derek J creators_name: Richards, A Mark creators_name: Nicholls, Stephen J creators_name: Chan, Mark Y creators_name: Muthiah, Mark D creators_name: Sanyal, Arun creators_name: Sperling, Laurence S 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 ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D14 divisions: GA2 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 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. 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. date: 2025-01-07 date_type: published publisher: Ovid Technologies (Wolters Kluwer Health) official_url: https://doi.org/10.1161/circulationaha.124.070535 full_text_type: other language: eng verified: verified_manual elements_id: 2345491 doi: 10.1161/CIRCULATIONAHA.124.070535 medium: Print-Electronic lyricists_name: Brown, Adrian lyricists_name: Hausenloy, Derek lyricists_id: ATURN01 lyricists_id: DHAUS05 actors_name: Allington-Smith, Dominic actors_id: DAALL44 actors_role: owner full_text_status: restricted publication: Circulation volume: 151 number: 1 pagerange: 98-119 event_location: United States issn: 0009-7322 citation: Chew, Nicholas WS; Mehta, Anurag; Goh, Rachel Sze Jen; Zhang, Audrey; Chen, Yiming; Chong, Bryan; Chew, Han Shi Jocelyn; ... Sperling, Laurence S; + view all <#> Chew, Nicholas WS; Mehta, Anurag; Goh, Rachel Sze Jen; Zhang, Audrey; Chen, Yiming; Chong, Bryan; Chew, Han Shi Jocelyn; Shabbir, Asim; Brown, Adrian; Dimitriadis, Georgios K; Huang, Daniel Q; Foo, Roger; le Roux, Carel W; Figtree, Gemma A; Fudim, Marat; Pandey, Ambarish; Mamas, Mamas A; Hausenloy, Derek J; Richards, A Mark; Nicholls, Stephen J; Chan, Mark Y; Muthiah, Mark D; Sanyal, Arun; Sperling, Laurence S; - view fewer <#> (2025) Cardiovascular-Liver-Metabolic Health: Recommendations in Screening, Diagnosis, and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease in Cardiovascular Disease via Modified Delphi Approach. Circulation , 151 (1) pp. 98-119. 10.1161/CIRCULATIONAHA.124.070535 <https://doi.org/10.1161/CIRCULATIONAHA.124.070535>. document_url: https://discovery.ucl.ac.uk/id/eprint/10203097/1/Hausenloy_Liver%20Heart%20Guideline16_Circulation.pdf