Evidence mapPaperPMID 41711215Full record

ReviewESC heart failure2026

Heart failure with preserved ejection fraction beyond the heart: exploring the heart-liver-pancreas axis.

Han Naung Tun, Omar Rahal, Ivan R Figueroa Baez, Omar Santana-Sánchez, Timothy Gardner

Abstract readReview
In one paragraph

Review in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Han Naung TunGeisel School of Medicine at Dartmouth, Hanover, NH, USA.
Omar RahalEnglish Division, Medical University of Warsaw, Warsaw, Poland.ORCID 0009-0004-8811-9678
Ivan R Figueroa BaezSan Juan City Hospital Internal Medicine Training Program, San Juan, Puerto Rico.
Omar Santana-SánchezVA Caribbean Healthcare System, Internal Medicine Training Program, San Juan, Puerto Rico.
Timothy GardnerCenter for Digestive Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

It has become increasingly recognized that heart failure with a preserved ejection fraction (HFpEF) results from an inflammatory process, congestion, and metabolic dysbiosis rather than an intrinsic structural heart abnormality. Recent studies have highlighted the close link between the heart, the liver, and the pancreas, which are organically connected via the same inflammatory processes and pathways. Liver congestion and fibrosis are responsible for the inflammatory process and the lack of metabolic adaptation, whereas pancreatic ischaemia and insufficiency of the exocrine glands aggravate malnutrition and cachexia, worsening the heart condition. Acute pancreatitis may cause heart failure and arrhythmia through injury and systemic inflammatory response syndrome (SIRS), an inflammatory process mediated by the cytokines released during the injury process. Recognition of this hepato-pancreato-cardiac axis offers a paradigm shift towards integrated management of HFpEF, emphasizing anti-inflammatory, metabolic, and haemodynamic interventions. Future research integrating multi-organ imaging, inflammatory biomarkers, and therapeutic trials such as GLP-1 receptor agonists, SGLT2 inhibitors, and cytokine blockers will be critical to disrupt this tri-organ inflammatory circuit and improve outcomes in HFpEF.

Indexed as

Heart FailureLiverPancreasStroke VolumeHumansHeart failure with preserved ejection fraction (HFpEF)Hepato–pancreato–cardiac axisMetabolic dysfunction-associated steatotic liver disease (MASLD)Pancreatic exocrine insufficiencySystemic inflammation

Identifiers

PMID41711215
PMCPMC13108270

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.