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Liver disease and heart failure: Could NAFLD be affecting your heart health?
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Rico440
Rico440
Last activity on 07/31/2025 at 6:12 AM
Joined in 2025
Patient, Non-alcoholic fatty liver disease and NASH since 2025
1 comment posted | 1 in the Non-alcoholic fatty liver disease and NASH Forum
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I’m well aware of this. I believe this is what I have, but since my cardiac output is not affected my doctors say I don’t match the diagnosis. How did you hear about this? What other info can you provide?
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Somya.P
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Somya.P
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Last activity on 07/31/2025 at 10:50 AM
Joined in 2023
681 comments posted | 10 in the Non-alcoholic fatty liver disease and NASH Forum
23 of their responses were helpful to members
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@Rico440 Hi there,
Thanks so much for sharing your experience, and you're absolutely right: preload reserve failure often goes unrecognized because resting cardiac output can still appear normal, especially in early stages. That’s why many patients are told everything looks “fine,” even when they’re clearly not feeling well.
I first came across this through a research paper that explored the link between NAFLD and heart failure with preserved ejection fraction (HFpEF), and how liver congestion can impair preload reserve without obvious signs in standard tests. Here’s the reference in case it’s helpful:
Salah HM, Pandey A, Soloveva A, et al. Relationship of Nonalcoholic Fatty Liver Disease and Heart Failure With Preserved Ejection Fraction. JACC Basic Transl Sci. 2021;6(11):918-932. Published 2021 Nov 22.
You might consider sharing this with your care team, it could help open the door to further testing or at least a more thorough discussion.
Thanks again for speaking up. If you ever want to share more or connect with others dealing with the same uncertainty, you’re more than welcome here.
Take care,
Somya from the Carenity team 🌼Salah HM, Pandey A, Soloveva A, et al. Relationship of Nonalcoholic Fatty Liver Disease and Heart Failure With Preserved Ejection Fraction. JACC Basic Transl Sci. 2021;6(11):918-932. Published 2021 Nov 22.

Although there is an established bidirectional relationship between heart failure with reduced ejection fraction and liver disease, the association between heart failure with preserved ejection fraction (HFpEF) and liver diseases, such as nonalcoholic fatty liver disease (NAFLD), has not been well e …
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Somya from the Carenity team
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Somya.P
Community managerGood advisor
Somya.P
Community manager
Last activity on 07/31/2025 at 10:50 AM
Joined in 2023
681 comments posted | 10 in the Non-alcoholic fatty liver disease and NASH Forum
23 of their responses were helpful to members
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Hello everyone,
I wanted to bring your attention to an important and often overlooked connection between liver disease and heart health, especially for those living with NAFLD.
In some cases, NAFLD can lead to something called preload reserve failure, a form of heart failure that isn’t easy to detect with standard heart tests. Invasive cardiopulmonary exercise testing (iCPET) can reveal how the liver disease obstructs blood returning to the heart, reducing cardiac output and causing heart failure symptoms.
This condition is still not widely recognized, but even early-stage NAFLD can disrupt the pressure in your liver and affect your heart’s ability to function under stress, particularly during exercise.
If you’ve been struggling with shortness of breath, unexplained fatigue, or symptoms that resemble heart failure, it could be time to look at your liver.
👉 Have you ever felt like something was wrong, even when your test results came back “normal”?
👉 Have you been diagnosed with NAFLD or NASH and experienced symptoms that affected your daily stamina or breathing?
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Let’s open this conversation to share knowledge and support. Your voice could help someone else get the diagnosis they need. 💬
Take care,
Somya from the Carenity team 🌼