Cardiac abnormalities in hepatic cirrhosis

Alexandru MIHAILOVICI, Gabriel VILCEANU, Ionuţ DONOIU, Octavian ISTRATOAIE, Diana TUDORASCU and Dan Ionut GHEONEA

ABSTRACT

Cirrhotic cardiomyopathy (CCM) is a term used to define a constellation of characteristics that illustrate abnormal cardiac structure and function in patients with cirrhosis. These encompass systolic and diastolic
dysfunction, electrophysiological and structural anomalies, both macroscopic and microscopic. At present, the prevalence of CCM remains unknown, mostly because the condition is typically latent and becomes noticeable when the patient is under stress, like exercise, drugs, hemorrhage or surgery. The essential clinical attributes of CCM consist of elevated baseline cardiac output, abnormal response of systolic contraction and diastolic relaxation as an answer to physiological, pharmacological or surgical stress and electrical anomalies (prolonged QT interval). In most cases, diastolic dysfunction predates systolic dysfunction, which tends to manifest only under stressful conditions. CCM diagnosis is still challenging, due to an absence of specific criteria. The prognosis is, as well, difficult to establish, but the severity of the diastolic dysfunction can be a risk marker for mortality.

Keywords: liver disease, cirrhosis, cardiomyopathy

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