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Dr. Marat Fudim (USA) discusses about NAFLD based on its progression, as a multi-system disease and how patients with a medical background of diabetes mellitus are at higher risk. He then reviews the association of NAFLD and various cardiac complications such as coronary heart disease, cardiac dysfunction, health failure, etc. Dr. Fudim also explains the etiological relationship between NAFLD and HFpEF which concludes that the downstream risk of HF was stronger in HFpEF in comparison with HFrEF. He also discusses the metabolic HFpEF phenotypes. Finally he presents the findings of a meta analysis of Incident Risk of HF after NAFLD.