Cardiohepatic interactions – cirrhotic cardiomyopathy and cardiac cirrhosis
More details
Hide details
Department of Internal Medicine, Medical University of Lublin, Poland
Andrzej Prystupa   

Department of Internal Medicine, Medical University of Lublin, Staszica 16, Lublin, Poland
J Pre Clin Clin Res. 2015;9(1):79–81
Interactions between the heart and the liver have been under investigation for many years. Cirrhotic cardiomyopathy characterized by hyperdynamic and hyporeactive circulation has been described in patients with advanced liver disease. Liver disease due to heart failure comprises acute hypoxic hepatitis due to reduced hepatic blood flow and congestive hepatopathy due to increased pressure within hepatic veins. Despite some specific characteristics, clinical presentation and treatment of cirrhotic heart disease and cardiac liver diseases are similar to the management of heart failure and liver cirrhosis of other origin.
Fouad YM, Yehia R. Hepato-cardiac disorders. World J Hepatol. 2014; 27; 6(1): 41–54.
Chayanupatkul M, Liangpunsakul S. Cirrhotic cardiomyopathy: review of pathophysiology and treatment. Hepatol Int. 2014; 8(3): 308–315.
Kowalski H, Abelmann WH. The cardiac output at rest in Laennec’s cirrhosis. J Clin Invest. 1953; 32: 1025–1033.
Moller S, Henriksen JH. Cirrhotic cardiomyopathy: a patho-physiological review of circulatory dysfunction in liver disease. Heart. 2002; 87: 9–15.
Krag A, Bendtsen F, Henriksen JH, Moller S. Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites. Gut. 2010; 59: 105–110.
Moller S, Henriksen JH. Cardiovascular complications of cirrhosis. Gut. 2008; 57: 268–278.
Lee SS, Marty J, Mantz J, Samain E, Braillon A, Lebrec D. Desensitization of myocardial beta-adrenergic receptors in cir-rhotic rats. Hepatology. 1990; 12: 481–485.
Liu H, Ma Z, Lee SS. Contribution of nitric oxide to the patho-genesis of cirrhotic cardiomyopathy in bile duct-ligated rats. Gastroenterology. 2000; 118: 937–944.
Henriksen JH, Fuglsang S, Bendtsen F, Christensen E, Møller S. Arterial compliance in patients with cirrhosis. High stroke volume/pulse pressure ratio as an index of elevated arterial compliance. Am J Physiol. 2001; 280: G584-G594.
Wong F, Girgrah N, Graba J, Allidina Y, Liu P, Blendis L. The cardiac response to exercise in cirrhosis. Gut. 2001;49:268–275.
Sampaio F, Pimenta J, Bettencourt N, Fontes-Carvalho R, Silva AP, Valente J, et al. Systolic and diastolic dysfunction in cirrhosis: a tissue-Doppler and speckle tracking echocardiography study. Liver Int. 2013; 33: 1158–1165.
Nagueh SF, Appleton CP, Gillebert TC, FESC, Marino PN, FESC, Oh JK, Smiseth OA, FESC, Waggoner AD, Flachskampf FA, FESC, Pellikka PA, Evangelista A Evaluation of left ventricular diastolic function by echocardiography: EAE/ASE Recommendations EJE 2009; 10(2): 165–193.
Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009; 22: 107–133.
Huonker M, Schumacher YO, Ochs A, Sorichter S, Keul J, Rossle M. Cardiac function and haemodynamics in alcoholic cirrhosis and effects of the transjugular intrahepatic portosystemic stent shunt. Gut. 1999; 44: 743–748.
Takeda Y, Yoneda T, Demura M, Miyamori I, Mabuchi H. Sodium-induced cardiac aldosterone synthesis causes cardiac hypertrophy. Endocrinology. 2000; 141: 1901–1904.
Karagiannakis DS, Vlachogiannakos J, Anastasiadis G, Vafiadis-Zouboulis I, Ladas SD. Frequency and severity of cirrhotic car-diomyopathy and its possible relationship with bacterial endo-toxemia. Dig Dis Sci. 2013; 58: 3029–3036.
Trevisani F, Merli M, Savelli F, Valeriano V, Zambruni A, Riggio O, Caraceni P, Domenicali M, Bernardi M. QT interval in patients with non-cirrhotic portal hypertension and in cirrhotic patients treated with transjugular intrahepatic porto-systemic shunt. J Hepatol. 2003; 38(4): 461–467.
Bal JS, Thuluvath PJ. Prolongation of QTc interval: relationship with etiology and severity of liver disease, mortality and liver transplantation. Liver Int. 2003; 23(4): 243–248.
Henriksen JH, Fuglsang S, Bendtsen F, Møller S. Arterial hypertension in cirrhosis: arterial compliance, volume distribution, and central haemodynamics. Gut. 2006; 55(3): 380–387.
Henrion J. Hypoxic hepatitis. Liver Int. 2012; 32(7): 1039–1052.
Birrer R, Takuda Y, Takara. Hypoxic hepatopathy: pathophysiology and prognosis. Intern Med. 2007; 46: 1063–1070.
Kavoliuniene A, Vaitiekiene A, Cesnaite G.Congestive hepatopathy and hypoxic hepatitis in heart failure: a cardiologist’s point of view. Int J Cardiol. 2013; 1; 166(3): 554–558.
Fuhrmann V, Kneidinger N, Herkner H, Heinz G, Nikfardjam M, Bojic A, Schellongowski P, Angermayr B, Kitzberger R, Warszawska J, Holzinger U, Schenk P, Madl C. Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients. Intensive Care Med. 2009; 35(8): 1397–405.
Gelow JM, Gelow AS, Desai CP, Hochberg JN, Glickman MM, Givertz JC. FangClinical predictors of hepatic fibrosis in chronic advanced heart failure. Circ Heart Fail. 2010; 3(1): 59–64.
Myers RP, Cerini R, Sayegh R, Moreau R, Degott C, Lebrec D, Lee SS. Cardiac hepatopathy: clinical, hemodynamic, and histologic characteristics and correlations. Hepatology 2003; 37: 393–400.
Dai DF, Swanson PE, Krieger EV, Liou IW, Carithers RL, Yeh MM. Congestive hepatic fibrosis score: a novel histologic assessment of clinical severity. Mod Pathol. 2014; 27(12):1552–1558.
Allen LA1, Felker GM, Pocock S, McMurray JJ, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB; CHARM Investigators. Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program. Eur J Heart Fail. 2009; 11(2): 170–177.
Lau GT, Tan HC, Kritharides L. Type of liver dysfunction in heart failure and its relation to the severity of tricuspid regurgitation. Am J Cardiol. 2002; 90(12): 1405–1409.
Møller S, Bernardi M. Interactions of the heart and the liver. Eur Heart J. 2013; 34(36): 2804–2811.
Li P, Robertson TA, Zhang Q, Fletcher LM, Crawford DH, Weiss M, Roberts MS. Hepatocellular necrosis, fibrosis and microsomal activity determine the hepatic pharmacokinetics of basic drugs in right-heart-failure-induced liver damage. Pharm Res. 2012; 29(6): 1658–1669.
Chokshi A1, Cheema FH, Schaefle KJ, Jiang J, Collado E, Shahzad K, Khawaja T, Farr M, Takayama H, Naka Y, Mancini DM, Schulze PC. Hepatic dysfunction and survival after orthotopic heart transplantation: application of the MELD scoring system for outcome prediction. J Heart Lung Transplant. 2012; 31(6): 591–600.
Crespo-Leiro MG1, Robles O, Paniagua MJ, Marzoa R, Naya C, Flores X, Suárez F, Gómez M, Grille Z, Cuenca JJ, Castro-Beiras A, Arnal F. Reversal of cardiac cirrhosis following orthotopic heart transplantation. Am J Transplant. 2008; 8(6): 1336–1339.
McMurray JJ, Adamopoulos S, Anker SD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012; 14: 803–869.
Lee WM1, Stravitz RT, Larson AM. Introduction to the revised American Association for the Study of Liver Diseases Position Paper on acute liver failure 2011. Hepatology. 2012; 55(3): 965–967.
Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ; American Gastroenterological Association; American Association for the Study of Liver Diseases; American College of Gastroenterology. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology. 2012; 142(7): 1592–1609.