A Perspective on Cirrhotic Cardiomyopathy

Timoh, Tendoh; Protano, Marion Anna; Wagman, Gabriel; Bloom, Michelle E.; Vittorio, Timothy J.

doi:10.1016/j.transproceed.2011.01.188

Cited by 49 publications

(47 citation statements)

References 27 publications

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“…There is a rise in CO, associated with high NO levels, accumulation of endocannabinoids and other vasodilators. These substances increases cyclic guanosine monophosphate (cGMP) leves, which inhibits cyclic adenosine monophosphate (cAMP) in cardiomyocites, responsible for calcium influx and greater contractile force (Figure 1,2) [7]. Myocardial cells analysis show a reduction in plasmatic membrane fluidity due to cholesterol deposition, which difficult the interaction of substances such as beta-adrenergic receptors and G-proteins [7,8].…”

Section: Physiopathologymentioning

confidence: 99%

“…These substances increases cyclic guanosine monophosphate (cGMP) leves, which inhibits cyclic adenosine monophosphate (cAMP) in cardiomyocites, responsible for calcium influx and greater contractile force (Figure 1,2) [7]. Myocardial cells analysis show a reduction in plasmatic membrane fluidity due to cholesterol deposition, which difficult the interaction of substances such as beta-adrenergic receptors and G-proteins [7,8]. The ventricular myocite may also have a decrease in potassium channels function, which leads to a suboptimal cardiac relaxation, and consequent diastolic dysfunction [8,9].…”

Section: Physiopathologymentioning

confidence: 99%

“…Clinical repercussion of this pathway is a blunted myocardial function and an increase in cardiac biomarkers [7].…”

Section: Physiopathologymentioning

confidence: 99%

“…Electromechanical uncoupling is described as a dyssynchrony between electrical stimulus and systolic mechanical response of the heart, taking to progressive loss of myocardial function and congestive heart failure in these patients1 [7]. The chronotropic incompetence is characterized by inability of sinus node to respond to physiological or pharmacological stimuli [23], an determinant fact in CCM physiopathology.…”

Section: Electrocardiogrammentioning

confidence: 99%

“…Clinical features of CCM may occur with patients with an apparently normal cardiac function, since chronic adaptation of the cardiomyocyte to the cirrhotic environment leads to all those cellular modifications [7].…”

Section: Clinical Featuresmentioning

confidence: 99%

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Cirrhotic cardiomyopathy: we already know. What comes next?

Mocarzel¹,

Bicca²,

Jarske³

et al. 2017

Dig Sys

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Cirrhotic Cardiomyopathy is a recently recognized condition consisting of myocardial dysfunction manifested in cirrhotic patients in the absence of previous cardiac disease. The underlying pathogenetic mechanisms includes a "miocardiotoxic" environment that leads to a blunted heart response to stress, whether physical or pharmacological. This condition is now better understood and can be diagnosed supported clinical, by laboratory electrocardiography and echocardiography criteria. Clinically, systolic incompetence is most evident when cirrhotic patients are placed under stress, whether physical or pharmacological. Despite of being well understood, there is a lack of knowledge to a proper practical application. Recent case reports have suggested that CCM must be treated early because it may be an triggering factor for cirrhosis complications. Studies are needed to identify potential treatments that alter the natural history of heart disease in cirrhotic patients, especially in the phases in which the patients are asymptomatic.

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Section: Physiopathologymentioning

confidence: 99%

Section: Physiopathologymentioning

confidence: 99%

“…Clinical repercussion of this pathway is a blunted myocardial function and an increase in cardiac biomarkers [7].…”

Section: Physiopathologymentioning

confidence: 99%

Section: Electrocardiogrammentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

See 3 more Smart Citations

Cirrhotic cardiomyopathy: we already know. What comes next?

Mocarzel¹,

Bicca²,

Jarske³

et al. 2017

Dig Sys

View full text Add to dashboard Cite

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Sarcopenia in Cirrhosis: Looking Beyond the Skeletal Muscle Loss to See the Systemic Disease

2019

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Sarcopenia is a common complication of cirrhosis and is defined as a progressive and generalized loss of skeletal muscle mass, strength, and function. Sarcopenia is associated with poor prognosis and increased mortality. How sarcopenia and muscle wasting relate to such poor outcomes requires looking beyond the overt muscle loss and at this entity as a systemic disease that affects muscles of vital organs including cardiac and respiratory muscles. This review explores the pathophysiological pathways and mechanisms that culminate in poor outcomes associated with sarcopenia. This provides a launching pad to identify potential targets for therapeutic intervention and optimization to improve patient outcomes.

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Preexisting atrial fibrillation and cardiac complications after liver transplantation

Bargehr

Trejo-Gutiérrez

Patel³

et al. 2015

Liver Transpl

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Atrial fibrillation (AF) is the most common cardiac arrhythmia, and it is associated with increased cardiovascular morbidity and all-cause mortality. Our aim was to determine the impact of preexisting AF on patients undergoing liver transplantation (LT). A retrospective case-control study was performed. Records from patients who underwent LT between January 2005 and December 2008 at Mayo Clinic Florida were reviewed. Patients with preexisting AF were identified and matched to patients who did not have a diagnosis of AF. Thirty-two of 717 LT recipients (4.5%) had AF before LT. These patients were compared to a control group of 63 LT recipients. Pre-LT left ventricular hypertrophy (P 5 0.03), a history of congestive heart failure (P 5 0.04), and a history of stroke or transient ischemic attack (P 5 0.03) were significantly more prevalent in patients with AF versus controls. Intraoperative adverse cardiac events (P 5 0.02) and AF-related adverse postoperative events (P < 0.001) were more common in the recipients with known AF. Six patients with paroxysmal AF (19%) developed chronic/ persistent AF postoperatively. Graft survival and patient survival were similar in the groups. Although patients with AF had a higher incidence of intraoperative cardiac events, a higher cardiovascular morbidity rate, and a complicated postoperative course, this did not affect overall graft and patient survival. Liver Transpl 21:314-320, 2015. V C 2014 AASLD. Atrial fibrillation (AF) is the most common cardiac arrhythmia with an estimated incidence of 28.3 per 1000 person-years in the United States. 1 The prevalence of AF is 0.95% to 2.3% in the general population; however, it is more prevalent in men and older individuals. 2-4 AF affects approximately 2.3 million Americans, and it is projected that more than 5.6 million Americans will have this condition by 2050. 3 Liver transplantation (LT) outcomes have improved in the last 2 decades, but cardiovascular complications remain a leading cause of death in LT recipients. 5-7 These complications have been attributed to immunosuppressive regimens and preexisting cardiac disease. 8,9 For this reason, LT candidates undergo an extensive preoperative cardiac assessment to ensure adequate function. 10,11 It is known that AF is associated with an increased risk of stroke, heart failure, and all-cause mortality in the general population; however, the impact of AF on patients undergoing LT is largely unknown. 12,13 Our aim in this study was to determine the morbidity and mortality associated with AF in patients undergoing LT. PATIENTS AND METHODSA retrospective analysis was performed of all patients who underwent LT between January 2005 and December 2008 at our institution. This study was reviewed

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A Perspective on Cirrhotic Cardiomyopathy

Cited by 49 publications

References 27 publications

Cirrhotic cardiomyopathy: we already know. What comes next?

Cirrhotic cardiomyopathy: we already know. What comes next?

Sarcopenia in Cirrhosis: Looking Beyond the Skeletal Muscle Loss to See the Systemic Disease

Preexisting atrial fibrillation and cardiac complications after liver transplantation

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