Cirrhotic cardiomyopathy: pathogenesis and clinical relevance

TY - JOUR

T1 - Cirrhotic cardiomyopathy

T2 - pathogenesis and clinical relevance

AU - Wiese, Signe

AU - Hove, Jens D

AU - Bendtsen, Flemming

AU - Møller, Søren

PY - 2014/3

Y1 - 2014/3

N2 - Cirrhosis is known to cause alterations in the systemic haemodynamic system. Cirrhotic cardiomyopathy designates a cardiac dysfunction that includes impaired cardiac contractility with systolic and diastolic dysfunction, as well as electromechanical abnormalities in the absence of other known causes of cardiac disease. This condition is primarily revealed by inducing physical or pharmacological stress, but echocardiography is excellent at revealing diastolic dysfunction and might also be used to detect systolic dysfunction at rest. Furthermore, measurement of circulating levels of cardiac biomarkers could improve the diagnostic assessm+ent. Cirrhotic cardiomyopathy contributes to various complications in cirrhosis, especially as an important factor in the development of hepatic nephropathy. Additionally, cirrhotic cardiomyopathy seems to be associated with the development of heart failure in relation to invasive procedures such as shunt insertion and liver transplantation. Current pharmacological treatment is nonspecific and directed towards left ventricular failure, and liver transplantation is currently the only proven treatment with specific effect on cirrhotic cardiomyopathy.

AB - Cirrhosis is known to cause alterations in the systemic haemodynamic system. Cirrhotic cardiomyopathy designates a cardiac dysfunction that includes impaired cardiac contractility with systolic and diastolic dysfunction, as well as electromechanical abnormalities in the absence of other known causes of cardiac disease. This condition is primarily revealed by inducing physical or pharmacological stress, but echocardiography is excellent at revealing diastolic dysfunction and might also be used to detect systolic dysfunction at rest. Furthermore, measurement of circulating levels of cardiac biomarkers could improve the diagnostic assessm+ent. Cirrhotic cardiomyopathy contributes to various complications in cirrhosis, especially as an important factor in the development of hepatic nephropathy. Additionally, cirrhotic cardiomyopathy seems to be associated with the development of heart failure in relation to invasive procedures such as shunt insertion and liver transplantation. Current pharmacological treatment is nonspecific and directed towards left ventricular failure, and liver transplantation is currently the only proven treatment with specific effect on cirrhotic cardiomyopathy.

KW - Cardiomyopathies

KW - Hemodynamics

KW - Humans

KW - Liver Cirrhosis

KW - Liver Transplantation

KW - Prognosis

U2 - 10.1038/nrgastro.2013.210

DO - 10.1038/nrgastro.2013.210

M3 - Review

C2 - 24217347

SN - 1759-5045

VL - 11

SP - 177

EP - 186

JO - Nature Reviews Gastroenterology and Hepatology

JF - Nature Reviews Gastroenterology and Hepatology

IS - 3

ER -