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Indocyanine green clearance is a dynamic liver function test established for the evaluation of liver disease but is limited by the major influence of systemic circulation. We aimed to assess the role of Indocyanine green clearance in the evaluation of MASLD, together with cardiac function measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective controlled study of 77 patients who underwent metabolic and bariatric surgery (MBS) and 25 controls who underwent elective cholecystectomy. Indocyanine green clearance was measured and interpreted as plasma disappearance rate (PDR) and residual dose at 15 min (R15). Wedge liver biopsies were obtained during MBS and assessed using the Kleiner classification. In the observed group cardiac output and cardiac index were measured and used to evaluate the influence of cardiac function on liver function monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Indocyanine green clearance was significantly lower in the observed patients compared to controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). PDR was significantly associated with a pathological histological score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Cardiac output and cardiac index were independently associated with R15 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). PDR adjusted for cardiac output and cardiac index significantly corelated with liver fibrosis, revealing a relationship not evident in unadjusted measurements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Indocyanine green clearance reflects MASLD severity in MBS patients. Its diagnostic value is further enhanced by adjusting for cardiac function. This novel combined approach may improve noninvasive assessment of MASLD and support treatment individualization in patients preparing for MBS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08560-1","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T23:18:59Z","timestamp":1772320739000},"page":"1675-1685","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Heart Function on the Assessment of MASLD Using Indocyanine Green Clearance"],"prefix":"10.1007","volume":"36","author":[{"given":"Jure","family":"Salobir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Branislava","family":"Rankovi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadeja","family":"Pintar Kaliterna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"issue":"6","key":"8560_CR1","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.cgh.2018.10.017","volume":"17","author":"Y Lee","year":"2019","unstructured":"Lee Y, Doumouras AG, Yu J, Brar K, Banfield L, Gmora S, et al. 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Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics and Consent"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This manuscript was edited for language and clarity using AI-assisted tools (ChatGPT and Paperpal). These tools were employed solely to improve grammar, wording, and readability; they were not used for content generation, data analysis, or substantive contributions to the intellectual content of the work. After using these tools, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration of AI and AI-assisted Technologies in the Writing Process"}},{"value":"MASLD and MASH were coined to more accurately represent the disease, which was, apart from a small difference in the definition, formerly (and in some cases still) known as non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Due to a better understanding of the disease pathophysiology and potentially stigmatizing terminology of \u201cfatty\u201d and \u201cnonalcoholic\u201d the name has been changed to MASLD and MASH, which more accurately represent the disease. Although several of the original studies cited in this manuscript were conducted and published using the NAFLD\/NASH terminology, the present manuscript consistently applies the updated MASLD\/MASH nomenclature throughout all sections to ensure clarity and terminological consistency.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of MASLD, MASH, NAFLD and NASH Terminology"}}]}}