Relationship between Heart Disease and Liver Disease: A Two-Way Street

Abstract

In clinical practice, combined heart and liver dysfunctions coexist in the setting of the main heart and liver diseases because of complex cardiohepatic interactions. It is becoming increasingly crucial to identify these interactions between heart and liver in order to ensure an effective management of patients with heart or liver disease to provide an improvement in overall prognosis and therapy. In this review, we aim to summarize the cross-talk between heart and liver in the setting of the main pathologic conditions affecting these organs. Accordingly, we present the clinical manifestation, biochemical profiles, and histological findings of cardiogenic ischemic hepatitis and congestive hepatopathy due to acute and chronic heart failure, respectively. In addition, we discuss the main features of cardiac dysfunction in the setting of liver cirrhosis, nonalcoholic fatty liver disease, and those following liver transplantation.

Role of Oxidative Stress in Hepatic and Extrahepatic Dysfunctions during Nonalcoholic Fatty Liver Disease (NAFLD)

“…The main effect on blood vessels during NAFLD is ED, which is associated with increased ROS levels. The ROS increment occurs together with NO·– levels and nitric oxide synthase (NOS) uncoupling [ 89 , 90 ]. NO·– reacts with excessive O 2 · − , forming peroxynitrite (ONOO·–), a potent oxidant with cytotoxic activity, that generates vasoconstriction and decreases the NO bioavailability, affecting the vasodilator response [ 91 ].…”

“…During NAFLD, the inflammatory state induces cardiokine synthesis and secretion of TGF- β 1, Ang-II, endothelin-1 (ET-1), and urotensin II, whose increase is related to the development of OS [ 90 , 91 ].…”

Special Issue on “Cellular and Molecular Mechanisms Underlying the Pathogenesis of Hepatic Fibrosis”

“…The 'heart-liver axis' for example mediates the bidirectional communication between heart and liver and affects many aspects of inter-cellular and inter-organ communication related to inflammation and systemic energy metabolism. El Hadi and colleagues explain how acute and chronic heart failure can lead to acute hepatic injury and chronic congestive hepatopathy and vice versa, how liver disease can provoke the development of heart systolic and diastolic dysfunctions [50]. As the authors mentioned, early recognition of clinical signs and symptoms of simultaneous heart and liver injury has led to important benefits in terms of reduction of morbidity and mortality [50].…”

“…El Hadi and colleagues explain how acute and chronic heart failure can lead to acute hepatic injury and chronic congestive hepatopathy and vice versa, how liver disease can provoke the development of heart systolic and diastolic dysfunctions [50]. As the authors mentioned, early recognition of clinical signs and symptoms of simultaneous heart and liver injury has led to important benefits in terms of reduction of morbidity and mortality [50]. Similarly, Buniatian et al points to a close connection of the brain in the pathogenesis of liver fibrosis [51].…”

Parallels between non-alcoholic fatty liver disease and non-alcoholic fatty pancreatic disease: looking for points of contact or regard through the lens of metabolic syndrome

“…Если о НАЖБП известно достаточно много и доказан прогрессирующий характер течения через неалкогольный стеатогепатит (НАСГ) в фиброз и цирроз печени, а затем и гепатоцеллюлярную карциному [4,13,21,23,44,84,102], то в отношении НАЖБПЖ эти сведения еще только начинают накапливаться. Несмотря на это, уже представлены данные, подтверждающие проградиентное течение НАЖБПЖ с трансформацией в неалкогольный стеатопанкреатит, фиброз, а затем и рак ПЖ.…”