An update on cirrhotic cardiomyopathy

Möller, Sören; Danielsen, Karen Vagner; Wiese, Signe; Hove, Jens D.; Bendtsen, Flemming

doi:10.1080/17474124.2019.1587293

Cited by 46 publications

(63 citation statements)

References 73 publications

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“…CCM complicates several therapeutic approaches used in cirrhosis and heart failure. Although beta blockers are contraindicated in decompensated cirrhosis with ascites, these drugs have been shown to normalize the prolonged QT interval and might reduce the hyperdynamic load [63]. ACE inhibitors and angiotensin receptor blockers (ARBs) are contraindicated in presence of ascites because of the risk of hypotension and hepatic-renal syndrome [63].…”

Section: Managementmentioning

confidence: 99%

“…Although beta blockers are contraindicated in decompensated cirrhosis with ascites, these drugs have been shown to normalize the prolonged QT interval and might reduce the hyperdynamic load [63]. ACE inhibitors and angiotensin receptor blockers (ARBs) are contraindicated in presence of ascites because of the risk of hypotension and hepatic-renal syndrome [63]. LT may be an effective treatment forend-stage liver disease associated with CCM since it has been shown to reverse cardiac dysfunctionand electrophysiological abnormalities [63].…”

Section: Managementmentioning

confidence: 99%

“…ACE inhibitors and angiotensin receptor blockers (ARBs) are contraindicated in presence of ascites because of the risk of hypotension and hepatic-renal syndrome [63]. LT may be an effective treatment forend-stage liver disease associated with CCM since it has been shown to reverse cardiac dysfunctionand electrophysiological abnormalities [63]. However, many cardiac complications have been reported in patients with CCM undergoing LT [64].…”

Section: Managementmentioning

confidence: 99%

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Relationship between Heart Disease and Liver Disease: A Two-Way Street

Hadi

Vincenzo

Rossato

2020

Cells

112

125

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In clinical practice, combined heart and liver dysfunctions coexist in the setting of the main heart and liver diseases because of complex cardiohepatic interactions. It is becoming increasingly crucial to identify these interactions between heart and liver in order to ensure an effective management of patients with heart or liver disease to provide an improvement in overall prognosis and therapy. In this review, we aim to summarize the cross-talk between heart and liver in the setting of the main pathologic conditions affecting these organs. Accordingly, we present the clinical manifestation, biochemical profiles, and histological findings of cardiogenic ischemic hepatitis and congestive hepatopathy due to acute and chronic heart failure, respectively. In addition, we discuss the main features of cardiac dysfunction in the setting of liver cirrhosis, nonalcoholic fatty liver disease, and those following liver transplantation.

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Relationship between Heart Disease and Liver Disease: A Two-Way Street

Hadi

Vincenzo

Rossato

2020

Cells

112

125

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“…Early dynamic changes are largely driven by humoral responses. Splanchnic arterial vasodilation and a reduced hepatic capacity to metabolize vasoactive agents leads to a reduced effective arterial circulating volume and the activation of the central baroreceptors, leading to the activation of the sympathetic nervous system and the renin-angiotensinaldosterone system (RAAS) (see Figure 1) [4]. This leads to the development of a hyperdynamic circulation, which is defined by an increased cardiac output, reduced arterial blood pressure, reduced vascular resistance, and increased heart rate [8].…”

Section: Pathophysiologymentioning

confidence: 99%

“…It is present in both adult and paediatric patients with cirrhosis and a major cause for morbidity and mortality [2]. The Gastroenterology World Congress 2005 defined a triad (Table 1) of clinical features associated with cirrhotic cardiomyopathy, such as systolic dysfunction, seen as a blunting of the usual cardiac response to stress; diastolic dysfunction; and electrical dysfunction [3,4]. The technical definition [5] (Table 1) has not kept pace with recent advances in cardiac imaging and the diagnosis of systolic and diastolic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Cirrhotic Cardiomyopathy

Longley

Tran

2021

Gastroenterology Insights

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Cirrhotic cardiomyopathy (CCM), cardiac dysfunction in end-stage liver disease in the absence of prior heart disease, is an important clinical entity that contributes significantly to morbidity and mortality. The original definition for CCM, established in 2005 at the World Congress of Gastroenterology (WCG), was based upon known echocardiographic parameters to identify subclinical cardiac dysfunction in the absence of overt structural abnormalities. Subsequent advances in cardiovascular imaging and in particular myocardial deformation imaging have rendered the WCG criteria outdated. A number of investigations have explored other factors relevant to CCM, including serum markers, electrocardiography, and magnetic resonance imaging. CCM characteristics include a hyperdynamic circulatory state, impaired contractility, altered diastolic relaxation, and electrophysiological abnormalities, particularly QT interval prolongation. It is now known that cardiac dysfunction worsens with the progression of cirrhosis. Treatment for CCM has traditionally been limited to supportive efforts, but new pharmacological studies appear promising. Left ventricular diastolic dysfunction in CCM can be improved by targeted heart rate reduction. Ivabradine combined with carvedilol improves left ventricular diastolic dysfunction through targeted heart rate reduction, and this regimen can improve survival in patients with cirrhosis. Orthotopic liver transplantation also appears to improve CCM. Here, we canvass diagnostic challenges associated with CCM, introduce cardiac physiology principles and the application of echocardiographic techniques, and discuss the evidence behind therapeutic interventions in CCM.

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The hepato‐cardiac disorders in Tibetan residents with hepatic echinococcosis: A case–control echocardiography study

Zhou

Zhang

et al. 2022

J of Clinical Ultrasound

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Background: Clinical guidelines indicate that chronic highland exposure could induce pulmonary hypertension; chronic hepatic disease may affect cardiac structure and functions. However, the simultaneous impact of hepatic echinococcosis (HE) and chronic highland exposure on cardiac structure and function in Tibetan residents are under-investigated. Methods: One hundred and twenty patients with HE, 23 healthy high-altitude migrants with a mean residence time of 7.15 ± 1.12 years, and 46 healthy Tibetan permanent residents were enrolled in this study. All participants received comprehensive transthoracic echocardiography. Results: High-altitude migrants have a relatively lower pulmonary artery flow velocity (PV) and a slightly higher pulmonary artery mean pressure (PAMP) than the Tibetan permanent residents. Patients with HE presented relatively smaller dimensions of the main pulmonary artery and branches and a bigger right atrium and right ventricular cavity size than the two control groups. PV, PAMP and numbers of detectable tricuspid regurgitation jet velocity (TRJV), right ventricular fractional area change (RV_FAC), tricuspid annular plane systolic excursion (TAPSE), the ratio of tricuspid inflow velocities at early diastole to tricuspid annular early diastolic excursion velocity (RV_E/e 0 ) and right ventricular myocardial performance index (RV_MPI) were increased in patients with HE compared to the two control groups. Similarly, decreased LVEF and Impaired left ventricular diastolic function were identified in patients with HE compared to the two control groups. Conclusions: Patients with HE presented with impaired biventricular contractile performance and diastolic dysfunction.

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An update on cirrhotic cardiomyopathy

Cited by 46 publications

References 73 publications

Relationship between Heart Disease and Liver Disease: A Two-Way Street

Relationship between Heart Disease and Liver Disease: A Two-Way Street

Cirrhotic Cardiomyopathy

The hepato‐cardiac disorders in Tibetan residents with hepatic echinococcosis: A case–control echocardiography study

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