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Interactions of the heart and the liver.
Eur Heart J. 2013 Sep; 34(36):2804-11.EH

Abstract

There is a mutual interaction between the function of the heart and the liver and a broad spectrum of acute and chronic entities that affect both the heart and the liver. These can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. In chronic and acute cardiac hepatopathy, owing to cardiac failure, a combination of reduced arterial perfusion and passive congestion leads to cardiac cirrhosis and cardiogenic hypoxic hepatitis. These conditions may impair the liver function and treatment should be directed towards the primary heart disease and seek to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities termed cirrhotic cardiomyopathy. Electrophysiological abnormalities include prolonged QT interval, chronotropic incompetance, and electromechanical uncoupling. No specific therapy can be recommended, but it should be supportive and directed against the heart failure. Numerous conditions affect both the heart and the liver such as infections, inflammatory and systemic diseases, and chronic alcoholism. The risk and prevalence of coronary artery disease are increasing in cirrhotic patients and since the perioperative mortality is high, a careful cardiac evaluation of such patients is required prior to orthotopic liver transplantation.

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Authors+Show Affiliations

Møller S
Centre of Functional and Diagnostic Imaging and Research, Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Bernardi M
No affiliation info available

MeSH

Acute DiseaseChronic DiseaseHeart DiseasesHeart-Assist DevicesHemochromatosisHemodynamicsHumansInfectionsInflammationLiver DiseasesLiver Transplantation

Pub Type(s)

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

Language

eng

PubMed ID

23853073

Citation

Møller, Søren, and Mauro Bernardi. "Interactions of the Heart and the Liver." European Heart Journal, vol. 34, no. 36, 2013, pp. 2804-11.
Møller S, Bernardi M. Interactions of the heart and the liver. Eur Heart J. 2013;34(36):2804-11.
Møller, S., & Bernardi, M. (2013). Interactions of the heart and the liver. European Heart Journal, 34(36), 2804-11. https://doi.org/10.1093/eurheartj/eht246
Møller S, Bernardi M. Interactions of the Heart and the Liver. Eur Heart J. 2013;34(36):2804-11. PubMed PMID: 23853073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interactions of the heart and the liver. AU - Møller,Søren, AU - Bernardi,Mauro, Y1 - 2013/07/12/ PY - 2013/7/16/entrez PY - 2013/7/16/pubmed PY - 2014/4/17/medline KW - Alcoholic heart muscle disease KW - Cardiac hepatopathy KW - Cirrhosis KW - Cirrhotic cardiomyopathy KW - Congestive hepatopathy KW - Hepatopulmonary syndrome KW - Hyperdynamic circulation KW - Liver transplantation KW - Portal hypertension KW - Portopulmonary hypertension SP - 2804 EP - 11 JF - European heart journal JO - Eur Heart J VL - 34 IS - 36 N2 - There is a mutual interaction between the function of the heart and the liver and a broad spectrum of acute and chronic entities that affect both the heart and the liver. These can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. In chronic and acute cardiac hepatopathy, owing to cardiac failure, a combination of reduced arterial perfusion and passive congestion leads to cardiac cirrhosis and cardiogenic hypoxic hepatitis. These conditions may impair the liver function and treatment should be directed towards the primary heart disease and seek to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities termed cirrhotic cardiomyopathy. Electrophysiological abnormalities include prolonged QT interval, chronotropic incompetance, and electromechanical uncoupling. No specific therapy can be recommended, but it should be supportive and directed against the heart failure. Numerous conditions affect both the heart and the liver such as infections, inflammatory and systemic diseases, and chronic alcoholism. The risk and prevalence of coronary artery disease are increasing in cirrhotic patients and since the perioperative mortality is high, a careful cardiac evaluation of such patients is required prior to orthotopic liver transplantation. SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/23853073/Interactions_of_the_heart_and_the_liver_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/eht246 DB - PRIME DP - Unbound Medicine ER -