Cor Vasa 2013, 55(4):e391-e396 | DOI: 10.1016/j.crvasa.2013.06.002

Heart failure in patients with liver cirrhosis

Radek Pudil^a,*, Radek Pelouch^a, Rudolf Praus^a, Martina Vašatová^b, Petr Hůlek^c

^a I. interní kardioangiologická klinika, Lékařská fakulta Univerzity Karlovy v Hradci Králové a Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

^b Ústav klinické biochemie a diagnostiky, Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

^c II. interní gastroenterologická klinika, Lékařská fakulta Univerzity Karlovy v Hradci Králové a Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

Liver cirrhosis is associated with severe hemodynamic changes which include hyperdynamic circulation with increased cardiac output, heart rate and reduced systemic vascular resistance. The term cirrhotic cardiomyopathy is defined as the presence of chronic cardiac dysfunction, characterized by blunted contractile responsiveness to stress and altered diastolic relaxation with electrophysiological abnormalities (QT interval prolongation), all occurring in the absence of any other cardiac disease. The key role in diagnosis is played by 2-dimensional echocardiography, electrocardiography and various serum markers (natriuretic peptides). The prognosis of the patients with cirrhotic cardiomyopathy is affected by heart failure, which can develop during invasive procedures (surgery, insertion of a transjugular intrahepatic portosystemic shunting and liver transplantation). No accepted specific treatment of cirrhotic cardiomyopathy exists. The therapy should follow the recommendations for the treatment of liver cirrhosis and heart failure.

Keywords: Cirrhotic cardiomyopathy; Heart failure; Liver cirrhosis; Transjugular portosystemic shunt

Received: December 19, 2012; Revised: June 4, 2013; Accepted: June 8, 2013; Published: August 1, 2013  Show citation