| Cirrhotic Cardiomyopathy |
| Moon Young Kim , Soon Koo Baik |
| Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea |
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| ABSTRACT |
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Most patients with liver cirrhosis have hyperdynamic circulatory alterations with increased cardiac output,
and decreased systemic vascular resistance and arterial pressure. But, in spite of the increased resting cardiac
output, ventricular contractile response to stressful stimuli is attenuated in cirrhotic patients which is termed
as cirrhotic cardiomyopathy. The prevalence of cirrhotic cardiomyopathy remains unknown at present. Clinical
features include structural, histological, electrophysiological, systolic and diastolic dysfunction. Multiple factors
are considered as responsible, including impaired β-adrenergic receptor signal transduction, abnormal
membrane biophysical characteristics, and increased activity of cardiodepressant systems mediated by cGMP.
Generally, cirrhotic cardiomyopathy with overt severe heart failure is rare. However, major stresses on the
cardiovascular system such as liver transplantation, infections and insertion of transjugular intrahepatic
portosystemic shunts (TIPS) can unmask the presence of cirrhotic cardiomyopathy and thereby convert latent
to overt heart failure. Cirrhotic cardiomyopathy may also contribute to the pathogenesis of hepatorenal
syndrome and circulatory failure in liver cirrhosis. Because of the marked paucity of treatment studies, current
recommendations for management are empirical, nonspecific measures. Further studies for pathogenesis and
new therapeutic strategies in this area are required. (Korean J Hepatol 2007;13:20-26) |
| KeyWords:
Liver cirrhosis; Cardiomyopathy; Heart failure; Hypertension, portal |
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