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Cardiac Syndromes in liver Disease:A Clinical Conundrum

Journal of Clinical and Translational Hepatology 2023年第4期11卷 975-986页

作者： Milos Brankovic Paul Lee Nikolaos Pyrsopoulos Mark Klapholz Department of Medicine Rutgers New Jersey Medical SchoolNewarkNJUSA Transatlantic Cardiovascular Study Group BloomfieldNJUSA Division of Gastroenterology and Hepatology Department of MedicineRutgers New Jersey Medical SchoolNewarkNJUSA Division of Cardiology Heart Failure Prevention and Treatment ProgramRutgers New Jersey Medical SchoolNewarkNJUSA

Understanding the interaction between the heart and liver is pivotal for managing patients in whom both organs are affected.Studies have shown that cardio-hepatic interactions are bidirectional and that their identification,assessment,and treatment remain challenging.Congestive hepatopathy is a condition that develops in the setting of long-standing systemic venous congestion.If left untreated,congestive hepatopathy may lead to hepatic fibrosis.Acute Cardiogenic liver injury develops as a combination of venous stasis and sudden arterial hypoperfusion due to cardiac,circulatory,or pulmonary failure.The treatment of both conditions should be directed toward optimizing the cardiac substrate.Hyperdynamic syndrome may develop in patients with advanced liver disease and lead to multiorgan failure.Cirrhotic cardiomyopathy or abnormalities in pulmonary vasculature,such as hepatopulmonary syndrome and portopulmonary hypertension may also develop.Each complication has unique treatment challenges and implications for liver transplantation.The presence of atrial fibrillation and atherosclerosis in liver disease brings another layer of complexity,particularly in terms of anticoagulation and statin use.This article provides an overview of cardiac syndromes in liver disease,focusing on current treatment options and future perspectives.

关键词： liver disease Congestive hepatopathy Cardiogenic liver injury Cirrhotic cardiomyopathy Hepatopulmonary syndrome Portopulmonary hypertension

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