Cirrhotic Cardiomyopathy: A New Clinical Phenotype

Mocarzel, Luís Otávio; Rossi, Mariana Macedo; Miliosse, Bruna de Mello; Lanzieri, Pedro Gemal; Gismondi, Ronaldo Altenburg

doi:10.5935/abc.20170066

Cited by 9 publications

(17 citation statements)

References 20 publications

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“…Both IL-1b and TNF-α stimulate production of nitric oxide (NO) which is a strong inflammatory mediator [16] . The excessive production of nitric oxide and endothelin may be the cause of cardiomyocyte lesion [18] . Cellular infiltration and vascular changes in the present work could also caused by the increased levels of NO.…”

Section: Discussionmentioning

confidence: 99%

Possible Protective Effect of Propolis on Cardiac Muscle Injury Induced by Liver Fibrosis in Adult Male Albino Rat: Histological Study

Elbakary

Sadek

2018

Egyptian Journal of Histology

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Introduction: Most chronic liver diseases lead to cirrhotic cardiomyopathy that occurs as a late complication in 56% of the hepatic patients. Propolis is considered as a tonic that increases the body resistance to aging. It also decreases the risk of cardiovascular diseases and atherosclerosis. Aim of the work: was to study the possible protective role of propolis on the histological changes occurred in cardiac muscle secondary to liver fibrosis. Materials and Methods: 40 healthy male albino rats were randomly divided into 4groups including: control group (group I), propolis treated group (group II) given 20mg propolis once daily orally for 4 weeks, (group III) received 0.2 ml/100 gm carbon tetrachloride by subcutaneous injection for 4 weeks and (group IV) received both carbon tetrachloride and propolis at the same dose of group IIand III for the same period. At the end of the experiment, all the rats were sacrificed, and cardiac muscle was obtained and processed for light and electron microscopic examination. Results: Group III revealed widely separated cardiomyocytes with excessive connective tissue nuclei between them. Cytoplasmic vacuolations and marked fibrillolysis were observed. Cellular infiltration and dilated blood vessels were found. Excessive collagen fibers were detected by Mallory stain. Ultrastructural changes included irregular sarcomeres, interrupted intercalated disks, degenerated mitochondria and dilated sarcoplasmic reticulum. Group IV showed partial improvement with regular arrangement of cardiac fibers and sarcomeres. Conclusions: Use of propolis partially improved the histological changes that occurred in the cardiac muscle as a result of liver fibrosis.

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Section: Discussionmentioning

confidence: 99%

Possible Protective Effect of Propolis on Cardiac Muscle Injury Induced by Liver Fibrosis in Adult Male Albino Rat: Histological Study

Elbakary

Sadek

2018

Egyptian Journal of Histology

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“…Cirrhotic cardiomyopathy was defined in 2005 in Montreal, Canada, as a chronic cardiac dysfunction in patients with LC, in the absence of an intrinsic cardiac disease [7]. Recently, new diagnostic criteria were provided by an expert consensus [6].…”

Section: Definition Of Cirrhotic Cardiomyopathymentioning

confidence: 99%

“…Cirrhotic cardiomyopathy includes a variety of structural myocardial changes, systolic and diastolic dysfunction, and/ or electrophysiological abnormalities, associated with an augmented vascular function [8][9][10]. This cardiac dysfunction is usually asymptomatic at rest, and it is manifested as a suboptimal ventricular response at an increased demand such as LT, other major surgery, and infections [7]. Comparative diagnostic criteria for recognition of CCM, as they were provided in 2005 and 2019 consensus meetings, are described in Fig.…”

Section: Definition Of Cirrhotic Cardiomyopathymentioning

confidence: 99%

Cirrhotic Cardiomyopathy in the Era of Liver Transplantation: Time for Precise Stepwise Evaluation

Rimbaş

Rimbaș

Chitroceanu

et al. 2020

JGLD

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Liver cirrhosis (LC) is an important cause of mortality. Access to liver transplantation (LT) has significantly improved the prognosis of LC. A rigorous pre-transplant cardiac evaluation is mandatory, since cardiac dysfunction is considered the main cause of mortality after LT. Notwithstanding, the most updated pre-LT evaluation guidelines provide only an algorithm for the evaluation of major cardiovascular diseases, with no specific recommendations concerning cirrhotic cardiomyopathy (CCM), which is linked to various complications in LC, especially the development of heart failure after invasive procedures and surgical interventions, including LT. CCM is characterized by a cardiac dysfunction that includes systolic and/or diastolic dysfunction and/or electrophysiological abnormalities, in the absence of other known cardiac diseases. The role of the novel methods, tissue Doppler imaging and speckle tracking echocardiography, might be essential in the early detection of cardiac dysfunction, with prognosis implications in LC. All these new methods were only recently included in the CCM diagnosis algorithm. This review summarizes the old and novel techniques used for the diagnosis of CCM, with their diagnosis and prognostic role. It also highlights the strengths and the weaknesses of the new provided CCM diagnostic consensus, and proposes a step-by- step novel diagnostic algorithm, in order to better detect cardiac dysfunction.cirrhotic cardiomyopathy

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“…In cirrhotic patients, there is also an increase in circulating levels of vasoactive substances (e.g., endothelin, tumor necrosis factor, prostacyclins, and nitric oxide), of which the toxic effect of nitric oxide is of high importance. [3, 4].…”

Section: Introduction: the Influence Of Cirrhosis On The Cardiovasmentioning

confidence: 99%

“…Because CCM is oligosymptomatic or even asymptomatic, an early diagnosis represents a challenge for every physician, while its real prevalence is very limited. Diastolic dysfunction (due to myocardial fibrosis, hypertrophy of cardiomyocytes, and subendothelial edema) occurs before systolic impairment, which is generally observed in situations when an imbalance occurs between an increased demand for cardiac output and an impaired myocardial contractility (e.g., infections, surgery and intense physical exercises) [3, 5].…”

Section: Introduction: the Influence Of Cirrhosis On The Cardiovasmentioning

confidence: 99%

Syndecan-1: A Review on Its Role in Heart Failure and Chronic Liver Disease Patients’ Assessment

Miftode

Șerban

Timpau

et al. 2019

Cardiology Research and Practice

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The close connection and interaction between the cardiac and the liver functions are well-known, as cirrhotic cardiomyopathy is an important clinical entity which best describes the mutual pathogenical influence between these two organs. Due to the fact that cardiac dysfunction in patients with chronic hepatic disorders is oligosymptomatic or even asymptomatic, an early diagnosis represents a challenge for every physician. Syndecan-1—a transmembrane proteoglycan that exerts its functions mainly via its heparane sulfate chains—is a very promising biomarker, correlated not only with the degree of cardiac fibrosis but also with the severity of liver fibrosis. Many studies highlighted its role in the development of cardiac fibrosis or atherogenesis, being significantly correlated with the activity of angiotensin II. Multiple evidence revealed that syndecan-1 is also associated with tissue injury and may regulate inflammatory and regenerative responses, being considered a protective molecule that limits the inflammation and reduces cardiac remodelling and dysfunction after a myocardial infarction. Syndecan-1 may also be used as a reliable biomarker for the noninvasive assessment of liver fibrosis. Under various fibrogenetic conditions, shedding of syndecan's extracellular domain took place, becoming a soluble form that binds different growth factors and inhibits further fibrosis. This complex molecule is also involved in the lipid metabolism, by altering the clearance of cholesterol particles, and in chronic hepatitis, by enhancing the viral invasion of hepatocytes. Due to the growing interest in this biomarker, multiple studies aimed at revealing syndecan-1's potential benefits in the diagnosis and prognosis assessment in patients with heart failure or chronic liver disorders. In this review, we review the mechanisms by which syndecan-1 exerts its effects and the possible perspectives opened by its use as a dual cardio-hepatic biomarker.

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Cirrhotic Cardiomyopathy: A New Clinical Phenotype

Cited by 9 publications

References 20 publications

Possible Protective Effect of Propolis on Cardiac Muscle Injury Induced by Liver Fibrosis in Adult Male Albino Rat: Histological Study

Possible Protective Effect of Propolis on Cardiac Muscle Injury Induced by Liver Fibrosis in Adult Male Albino Rat: Histological Study

Cirrhotic Cardiomyopathy in the Era of Liver Transplantation: Time for Precise Stepwise Evaluation

Syndecan-1: A Review on Its Role in Heart Failure and Chronic Liver Disease Patients’ Assessment

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