Congestive hepatopathy and hypoxic hepatitis in heart failure: A cardiologist's point of view

Kavoliūnienė, Aušra; Vaitiekienė, Audronė; Čėsnaitė, Giedrė

doi:10.1016/j.ijcard.2012.05.003

Cited by 78 publications

(70 citation statements)

References 36 publications

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“…Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy (8) .The deleterious effects of HF on the liver are a consequence of two mechanisms: (1) hepatic congestion secondary to volume and pressure overload; and (2) reduced cardiac output and compromised liver perfusion causing hypoxic injury (9) . Changes in hepatic function that are proven by laboratory tests are significant in predicting the survival of patients with severe heart failure.…”

Section: Discussionmentioning

confidence: 99%

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Zaghla¹,

Sabawy²,

Gomma³

et al. 2015

JMSCR

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Section: Discussionmentioning

confidence: 99%

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Zaghla¹,

Sabawy²,

Gomma³

et al. 2015

JMSCR

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“…Although there is no consensus on terminology, "cardiac hepatopathy" has generally been used to describe any liver damage caused by cardiac disorders in the absence of other possible causes of liver damage (13)(14)(15)(16). In cardiac hepatopathy, the primary pathophysiology is either passive venous congestion that results in "congestive hepatopathy (CH)" or low cardiac output and arterial hypoperfusion that results in "acute cardiogenic liver injury (ACLI)" (14,15,17,18).…”

Section: Pathophysiology Of Liver Damagementioning

confidence: 99%

“…In cardiac hepatopathy, the primary pathophysiology is either passive venous congestion that results in "congestive hepatopathy (CH)" or low cardiac output and arterial hypoperfusion that results in "acute cardiogenic liver injury (ACLI)" (14,15,17,18). In literature, ischemic hepatitis, shock liver, or hypoxic hepatopathy have also been used instead of ACLI, however, we propose that ACLI provides more details about the underlying pathophysiological process (18,19).…”

Section: Pathophysiology Of Liver Damagementioning

confidence: 99%

“…Jaundice, tender hepatomegaly, hepatojugular reflux, ascites, and pulsatile liver are the main findings on physical examination (17,38). In a retrospective analysis of 661 patients referred to a "jaundice hotline" service, a primary cardiac cause is identified in eight patients (1.2%) as an underlying cause for jaundice (39).…”

Section: Clinical Findings and Implications Of The Laboratory Changesmentioning

confidence: 99%

“…In minority of cases, mental confusion, jaundice, flapping tremor, or hepatic coma might develop; however, in a patient with acute cardiocirculatory failure, mental confusion and coma generally represent cerebral hypoxia rather than hepatic encephalopathy (11,15,24,33). Fulminant hepatic failure has also been reported in rare cases of HF (52).…”

Section: Clinical Findings and Implications Of The Laboratory Changesmentioning

confidence: 99%

See 2 more Smart Citations

How to interpret liver function tests in heart failure patients?

Cagli

Başar²,

Tok³

et al. 2020

Turk J Gastroenterol

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Cardiac hepatopathy has generally been used to describe any liver damage caused by cardiac disorders in the absence of other possible causes of liver damage. Although there is no consensus on the terminology used, cardiac hepatopathy can be examined as congestive hepatopathy (CH) and acute cardiogenic liver injury (ACLI). CH is caused by passive venous congestion of the liver that generally occurs in the setting of chronic cardiac conditions such as chronic HF, constrictive pericarditis, tricuspid regurgitation, or right-sided heart failure (HF) of any cause, and ACLI is most commonly associated with acute cardiocirculatory failure resulting from acute myocardial infarction, acute decompensated HF, or myocarditis. Histologically, CH is characterized by sinusoidal dilation, replacement of hepatocytes with red blood cells extravasating from the sinusoids, and necrosis/apoptosis of zone 3 of the Rappaport acinus, and it could progress to cirrhosis in advanced cases. In ACLI, however, massive necrosis of zone 3 is the main histological finding. Primary laboratory findings of CH are elevated serum cholestasis markers including bilirubin, alkaline phosphatase, and γ-glutamyl-transpeptidase levels, whereas those of ACLI are a striking elevation in transaminase and lactate dehydrogenase levels. Both CH and ACLI have a prognostic value for identifying cardiovascular events and mortality and have some special implications in the management of patients undergoing ventricular assist device implantation or cardiac transplantation. There is no specific treatment for CH or ACLI other than treatment of the underlying cardiac disorder.

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Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

et al. 2020

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AST and ALT elevations had also been reported in patients with SARS caused by SARS-CoV. (37) Several case reports have described severe LFT abnormalities (18,38,39) or acute-on-chronic (40,41) liver failure in patients with COVID-19. Zhang et al. (33) reported that 1 of 82 deceased patients with COVID-19 had a hepatic cause of death, although it was not clear whether this patient had pre-existing liver disease.Elevated ALP was reported in 2%-5% of patients, (5,11,25,42) and elevated GGT was reported in 13%-54% of patients (weighted average: 23%). (5,11,19,42) The prevalence of total bilirubin elevations ranged between 1% and 18% of patients with COVID-19 on admission. (4,5,15,16,18,25,35,43) It should be realized, aRtICle INFoRMatIoN:

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Congestive hepatopathy and hypoxic hepatitis in heart failure: A cardiologist's point of view

Cited by 78 publications

References 36 publications

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

How to interpret liver function tests in heart failure patients?

Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

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