TABLE 1.

Summary of treatments for NAFLD and their impact on HFpEF.

Intervention	Impact on NAFLD	Impact on common risk factors, secretory factors, and EAT	Impact on HFpEF
Dietary intervention	Improve liver steatosis and fibrosis	Protect against diabetes and obesity	Dietary Intervention is associated with favorable prognosis of patients with HFpEF
Weight loss induced by exercise, caloric restriction, and bariatric surgery	Amelioration of hepatic steatosis or fibrosis	Reduce the risk of diabetes and improve insulin resistance; decrease levels of Inflammatory factors and EAT thickness	Improve cardiorespiratory fitness and exercise capacity
Statins	Improve histological liver damage in individuals with NAFLD/NASH	Have beneficial effects of anti-inflammation and reducing EAT	Reduce mortality rates of patients with HFpEF
Thiazolidinediones	Decrease hepatic inflammation, steatosis, fibrosis	Protect against diabetes; reduce inflammatory markers and alleviate the inflammation of EAT	Delay the development of HFpEF in animal models but lead to sodium retention in patients
Glucagon-like peptide-1 receptor agonists	Reduce the levels of liver enzymes and improved the NAFLD activity score	Lower blood glucose levels and body weight; have anti-inflammatory effects	Alleviate cardiometabolic dysfunction and improve cardiac function in animal models but lack of clinical trials
Sodium-glucose cotransporter 2 inhibitors	Improve steatosis and histological fibrosis; reduce liver fat and the levels of liver enzymes	Improve blood glucose and insulin resistance; decrease epicardial fat volume and CRP	Improvement in left ventricular diastolic function and cardiovascular outcomes in patients with HFpEF
Metformin	Fat accumulation and histological lesions in the liver are ameliorated; decrease the levels of aminotransaminase	Reduce EAT and have the effects of anti-inflammation	Improve clinical outcomes in patients with HFpEF but lack of evidence

NAFLD, non-alcoholic fatty liver disease; EAT, epicardial adipose tissue; HFpEF, heart failure with preserved ejection fraction; NASH, non-alcoholic steatohepatitis; CRP, C-reactive protein.