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Therapy insight: Cirrhotic cardiomyopathy.
Nat Clin Pract Gastroenterol Hepatol. 2006 Jun; 3(6):329-37.NC

Abstract

Liver cirrhosis is associated with several cardiovascular disturbances. These disturbances include hyperdynamic systemic circulation, manifested by an increased cardiac output and decreased peripheral vascular resistance and arterial pressure. Despite the baseline increase in cardiac output, cardiac function in patients with cirrhosis is abnormal in several respects. Patients show attenuated systolic and diastolic contractile responses to stress stimuli, electrophysiological repolarization changes, including prolonged QT interval, and enlargement or hypertrophy of cardiac chambers. This constellation of cardiac abnormalities is termed cirrhotic cardiomyopathy. It has been suggested that cirrhotic cardiomyopathy has a role in the pathogenesis of cardiac dysfunction and even overt heart failure after transjugular intrahepatic portosystemic shunt placement, major surgery and liver transplantation. Cardiac dysfunction contributes to morbidity and mortality after liver transplantation, even in many patients who have no prior history of cardiac disease. Depressed cardiac contractility contributes to the pathogenesis of hepatorenal syndrome, especially in patients with spontaneous bacterial peritonitis. Pathogenic mechanisms underlying cirrhotic cardiomyopathy include cardiomyocyte-membrane biophysical changes, attenuation of the stimulatory beta-adrenergic system and overactivity of negative inotropic systems mediated via cyclic GMP. The clinical features, general diagnostic criteria, pathogenesis and treatment of cirrhotic cardiomyopathy are discussed in this review.

Authors+Show Affiliations

Gaskari SA
Liver Unit, University of Calgary, Calgary, AB, Canada.
Honar H
No affiliation info available
Lee SS
No affiliation info available

MeSH

Cardiovascular AgentsHeart DiseasesHumansLiver CirrhosisLiver TransplantationPortasystemic Shunt, Transjugular IntrahepaticTreatment Outcome

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

16741552

Citation

Gaskari, Seyed A., et al. "Therapy Insight: Cirrhotic Cardiomyopathy." Nature Clinical Practice. Gastroenterology & Hepatology, vol. 3, no. 6, 2006, pp. 329-37.
Gaskari SA, Honar H, Lee SS. Therapy insight: Cirrhotic cardiomyopathy. Nat Clin Pract Gastroenterol Hepatol. 2006;3(6):329-37.
Gaskari, S. A., Honar, H., & Lee, S. S. (2006). Therapy insight: Cirrhotic cardiomyopathy. Nature Clinical Practice. Gastroenterology & Hepatology, 3(6), 329-37.
Gaskari SA, Honar H, Lee SS. Therapy Insight: Cirrhotic Cardiomyopathy. Nat Clin Pract Gastroenterol Hepatol. 2006;3(6):329-37. PubMed PMID: 16741552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapy insight: Cirrhotic cardiomyopathy. AU - Gaskari,Seyed A, AU - Honar,Hooman, AU - Lee,Samuel S, PY - 2005/11/04/received PY - 2006/03/10/accepted PY - 2006/6/3/pubmed PY - 2006/8/17/medline PY - 2006/6/3/entrez SP - 329 EP - 37 JF - Nature clinical practice. Gastroenterology & hepatology JO - Nat Clin Pract Gastroenterol Hepatol VL - 3 IS - 6 N2 - Liver cirrhosis is associated with several cardiovascular disturbances. These disturbances include hyperdynamic systemic circulation, manifested by an increased cardiac output and decreased peripheral vascular resistance and arterial pressure. Despite the baseline increase in cardiac output, cardiac function in patients with cirrhosis is abnormal in several respects. Patients show attenuated systolic and diastolic contractile responses to stress stimuli, electrophysiological repolarization changes, including prolonged QT interval, and enlargement or hypertrophy of cardiac chambers. This constellation of cardiac abnormalities is termed cirrhotic cardiomyopathy. It has been suggested that cirrhotic cardiomyopathy has a role in the pathogenesis of cardiac dysfunction and even overt heart failure after transjugular intrahepatic portosystemic shunt placement, major surgery and liver transplantation. Cardiac dysfunction contributes to morbidity and mortality after liver transplantation, even in many patients who have no prior history of cardiac disease. Depressed cardiac contractility contributes to the pathogenesis of hepatorenal syndrome, especially in patients with spontaneous bacterial peritonitis. Pathogenic mechanisms underlying cirrhotic cardiomyopathy include cardiomyocyte-membrane biophysical changes, attenuation of the stimulatory beta-adrenergic system and overactivity of negative inotropic systems mediated via cyclic GMP. The clinical features, general diagnostic criteria, pathogenesis and treatment of cirrhotic cardiomyopathy are discussed in this review. SN - 1743-4378 UR - https://www.unboundmedicine.com/medline/citation/16741552/Therapy_insight:_Cirrhotic_cardiomyopathy_ DB - PRIME DP - Unbound Medicine ER -