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Cardiac dysfunction in cirrhosis.
Best Pract Res Clin Gastroenterol. 2007; 21(1):125-40.BP

Abstract

Cirrhosis is known to be associated with numerous cardiovascular abnormalities. These include increased cardiac output and decreased arterial pressure and total peripheral resistance. Despite this increased baseline cardiac output, patients with cirrhosis show an attenuated systolic and diastolic function in the face of pharmacological, physiological and surgical stresses, as well as cardiac electrical abnormalities such as QT prolongation. These abnormalities have been termed cirrhotic cardiomyopathy. The pathogenic mechanisms that underlie this syndrome include impairment of the beta-adrenergic receptor signalling, cardiomyocyte plasma membrane function, intracellular calcium kinetics, and humoral factors such as endogenous cannabinoids, nitric oxide and carbon monoxide. Cirrhotic cardiomyopathy is believed to contribute to the cardiac dysfunction that can be observed in patients with transjugular intrahepatic portosystemic stent-shunt insertion and liver transplantation. Insufficient cardiac contractile function may also play a role in the pathogenesis of hepatorenal syndrome precipitated by spontaneous bacterial peritonitis. In this review, the clinical features, pathogenic mechanisms, clinical consequences and management options for cirrhotic cardiomyopathy are discussed.

Authors+Show Affiliations

Liver Unit, University of Calgary, Calgary, AB, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17223501

Citation

Lee, Ralph F., et al. "Cardiac Dysfunction in Cirrhosis." Best Practice & Research. Clinical Gastroenterology, vol. 21, no. 1, 2007, pp. 125-40.
Lee RF, Glenn TK, Lee SS. Cardiac dysfunction in cirrhosis. Best Pract Res Clin Gastroenterol. 2007;21(1):125-40.
Lee, R. F., Glenn, T. K., & Lee, S. S. (2007). Cardiac dysfunction in cirrhosis. Best Practice & Research. Clinical Gastroenterology, 21(1), 125-40.
Lee RF, Glenn TK, Lee SS. Cardiac Dysfunction in Cirrhosis. Best Pract Res Clin Gastroenterol. 2007;21(1):125-40. PubMed PMID: 17223501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac dysfunction in cirrhosis. AU - Lee,Ralph F, AU - Glenn,Tamara K, AU - Lee,Samuel S, PY - 2007/1/16/pubmed PY - 2007/3/27/medline PY - 2007/1/16/entrez SP - 125 EP - 40 JF - Best practice & research. Clinical gastroenterology JO - Best Pract Res Clin Gastroenterol VL - 21 IS - 1 N2 - Cirrhosis is known to be associated with numerous cardiovascular abnormalities. These include increased cardiac output and decreased arterial pressure and total peripheral resistance. Despite this increased baseline cardiac output, patients with cirrhosis show an attenuated systolic and diastolic function in the face of pharmacological, physiological and surgical stresses, as well as cardiac electrical abnormalities such as QT prolongation. These abnormalities have been termed cirrhotic cardiomyopathy. The pathogenic mechanisms that underlie this syndrome include impairment of the beta-adrenergic receptor signalling, cardiomyocyte plasma membrane function, intracellular calcium kinetics, and humoral factors such as endogenous cannabinoids, nitric oxide and carbon monoxide. Cirrhotic cardiomyopathy is believed to contribute to the cardiac dysfunction that can be observed in patients with transjugular intrahepatic portosystemic stent-shunt insertion and liver transplantation. Insufficient cardiac contractile function may also play a role in the pathogenesis of hepatorenal syndrome precipitated by spontaneous bacterial peritonitis. In this review, the clinical features, pathogenic mechanisms, clinical consequences and management options for cirrhotic cardiomyopathy are discussed. SN - 1521-6918 UR - https://www.unboundmedicine.com/medline/citation/17223501/Cardiac_dysfunction_in_cirrhosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-6918(06)00074-6 DB - PRIME DP - Unbound Medicine ER -