Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome

Zardi, Enrico Maria; Giorgi, Chiara; Dobrina, Aldo; Vecile, Elena; Zardi, Domenico Maria

doi:10.1002/med.21755

Cited by 3 publications

(4 citation statements)

References 73 publications

(127 reference statements)

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“…However, in the diagnosis of the diastolic dysfunction of the myocardium, doppler techniques are used [4,35]. Echocardiography with saline contrast helps diagnose the hepatopulmonary syndrome and portopulmonary hypertension in the case of patients with end stage liver disease (ESLD) with portal hypertension [58].…”

Section: Echocardiographymentioning

confidence: 99%

What’s New in Cirrhotic Cardiomyopathy?—Review Article

Bodys-Pełka

Kusztal

Raszeja‐Wyszomirska

et al. 2021

JPM

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Cirrhotic cardiomyopathy (CCM) is a relatively new medical term. The constant development of novel diagnostic and clinical tools continuously delivers new data and findings about this broad disorder. The purpose of this review is to summarize current facts about CCM, identify gaps of knowledge, and indicate the direction in which to prepare an updated definition of CCM. We performed a review of the literature using scientific data sources with an emphasis on the latest findings. CCM is a clinical manifestation of disorders in the circulatory system in the course of portal hypertension. It is characterized by impaired left ventricular systolic and diastolic dysfunction, and electrophysiological abnormalities, especially QT interval prolongation. However, signs and symptoms reported by patients are non-specific and include reduced exercise tolerance, fatigue, peripheral oedema, and ascites. The disease usually remains asymptomatic with almost normal heart function, unless patients are exposed to stress or exertion. Unfortunately, due to the subclinical course, CCM is rarely recognized. Orthotopic liver transplantation (OLTx) seems to improve circulatory function although there is no consensus about its positive effect, with reported cases of heart failure onset after transplantation. Researchers indicate a careful pre-, peri-, and post-transplant cardiac assessment as a crucial point in detecting CCM and improving patients’ prognosis. There is also an urgent need to update the CCM definition and establish a diagnostic algorithm for early diagnosis of CCM as well as a specific treatment of this condition.

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Section: Echocardiographymentioning

confidence: 99%

What’s New in Cirrhotic Cardiomyopathy?—Review Article

Bodys-Pełka

Kusztal

Raszeja‐Wyszomirska

et al. 2021

JPM

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“… 4 IPVD seems to have a limited impact on survival or other outcomes of patients with CLD. 1 , 5 As the only curable treatment for HPS is liver transplantation, 6 preventing CLD patients from developing HPS is of great importance. However, only 0.45% of CLD patients are diagnosed with HPS, and the diagnostic accuracy is only 22.5%, 7 highlighting the need for specific markers in this field.…”

Section: Introductionmentioning

confidence: 99%

“… 10 , 14 In contrast to the high success rate of the HPS experimental model, the incidence of HPS in CLD patients is relatively low. 6 This may partially explain why some markers or targets that are effective in experimental models are not appropriate for HPS patients. 14 Second, the levels of VEGF family members and their receptors in patients with CLD are usually elevated, 15 , 16 but only some patients will develop HPS.…”

Section: Introductionmentioning

confidence: 99%

Serum Soluble Vascular Endothelial Growth Factor Receptor 1 as a Potential Biomarker of Hepatopulmonary Syndrome

Li¹,

Wu²,

Wang³

et al. 2023

J Clin Transl Hepatol

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“…Additionally, the proportions of circulating vasoactive intestinal peptide, glucagon, tumour necrosis factor (TNF), prostacyclin, nitric oxide, endothelin-1, and endothelin-3, are not down-regulated by the liver and are raised. 2 Owing to these haemodynamic characteristics, patients with compensated or decompensated liver cirrhosis potentially suffer from various repercussions involving deficient cardiac health which usually is not discerned. 3 Besides, insufficient heart function could contribute to more hepatic damage.…”

Section: Introductionmentioning

confidence: 99%

Do you have to evaluate the heart of the cirrhotic patients?

Mohammed Hussien Ahmed,

Mohammed Said Radwan,

Ibrahim Fathi Amer

et al. 2023

J Pak Med Assoc

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Objective: To identify patients with occult cardiac dysfunction and its relationship with the severity of liver impairment.Method: This is a Judgment (Purposive) Sampling, cross-sectional study that was conducted at Kafrelsheikh University Hospital, Egypt, from November 2019 to December 2020, and comprised adult patients of either gender with liver cirrhosis. After detailed history, a clinical examination, pathological assessment and cardiac evaluation based on electrocardiogram and echocardiography, the patients were divided into three groups. Patients who had dyspnoea or cyanosis were in group A, those who did not have dyspnoea or cyanosis but had electrocardiogram and echocardiography abnormalities were in group B, and patients who did not have dyspnoea, cyanosis or electrocardiogram and echocardiography abnormalities were in group C. The severity of the liver disease wasevaluated using Child-Pugh and Model of End Liver Disease scores. Data was analysed using SPSS 20.Results: Of the 300 patients, 153(51%) were males and 147(49%) were females. The overall mean age was 55.1±5.1 years (range: 20-60 years). There were 58(19.33%) patients in group A, 108(36%) in group B and 134(44.66%) in group C. Group A patients showed higher Child-Pugh and Model of End Liver Disease scores than the other groups (p<0.05). Child-Pugh score >6 and Model of End Liver Disease score >37 yielded the best accuracy for detecting cardiac abnormalities in group B (p<0.05).Conclusion: There were significant cardiac changes in cirrhotic patients.Keywords: Liver cirrhosis, Electrocardiography, Cirrhotic cardiomyopathy, Hyperdynamic circulation

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Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome

Cited by 3 publications

References 73 publications

What’s New in Cirrhotic Cardiomyopathy?—Review Article

What’s New in Cirrhotic Cardiomyopathy?—Review Article

Serum Soluble Vascular Endothelial Growth Factor Receptor 1 as a Potential Biomarker of Hepatopulmonary Syndrome

Do you have to evaluate the heart of the cirrhotic patients?

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