B This article refers to 'Liver tests, cardiovascular outcomes and effects of empagliflozin in patients with heart failure and preserved ejection fraction: The EMPEROR-Preserved trial' by M. Böhm I et al i ., published in this issue on pages 1375-1383. b Heart failure (HF) is a global epidemic affecting more than 64 million people worldwide.[1] Acute and chronic liver injury, as evidenced by elevations in liver function tests (LFTs) are a common manifestation of acute and chronic HF and may reflect systemic hypoperfusion or chronic passive, venous congestion, respectively.[2] Several recently published reports have demonstrated the potential utility of LFTs in HF prognostication.[[3], [5], [7], [9], [11]] Specifically, reduced levels of albumin and elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, and alkaline phosphatase (ALP) have traditionally been associated with increased mortality and HF hospitalizations.[[3], [5], [7], [9], [11]] However, these prior studies examined the role of LFTs in those with acute HF irrespective of left ventricular ejection fraction (LVEF) or ambulatory HF with reduced ejection fraction (HFrEF). The authors excluded patients based on abnormal LFTs (see definition above), which may not completely capture patients with underlying liver disease. In conclusion, Böhm I et al i .[12] enhance the current understanding of the prognostic implications of LFTs in HF and provide new insights into the associations between elevated LFTs and ambulatory HFmrEF/HFpEF. [Extracted from the article]