Reply to: “Reassessing the causal relationship between liver diseases and cardiovascular outcomes” and “From liver to heart: Enhancing the understanding of cardiovascular outcomes in the UK Biobank”

We thank Xiang et al.1 and Zhang et al.2 for their interest in our article on the independent associations between liver disease activity (measured by iron corrected T1-mapping [cT1]) and risk of new onset cardiovascular disease (CVD) events and all-cause mortality.3 Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of morbidity and mortality from chronic liver disease (CLD) and is associated with increased CVD incidence and mortality.4 Efforts to move away from using liver biopsy for MASLD diagnosis and to replace it with non-invasive tests are advocated by both clinicians and patients.