Gananandan, Kohilan;
Wiese, Signe;
Moller, Soren;
Mookerjee, Rajeshwar P;
(2024)
Cardiac dysfunction in patients with cirrhosis and acute decompensation.
Liver International
10.1111/liv.15896.
(In press).
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Abstract
The prevalence of cirrhotic cardiomyopathy (CCM) has been reported as high as 60%–70% in patients with liver cirrhosis and is associated with various negative outcomes. There has been a growing understanding of CCM over recent years. Indeed, the development of imaging techniques has enabled new diagnostic criteria to be proposed by the Cirrhotic Cardiomyopathy Consortium. However, important unanswered questions remain over pathophysiological mechanisms, optimal diagnostic modalities and potential treatment options. While there has been an increasing volume of literature evaluating CCM, there is a lack of clarity on its implications in acute decompensation, acute-on-chronic liver failure and following interventions such as transjugular intrahepatic portosystemic shunt insertion and liver transplantation. This review aims to summarise the literature in these challenging domains and suggest where future research should focus. We conclude that systemic inflammation and structural myocardial changes are likely to be crucial in the pathophysiology of the disease, but the relative contribution of different components remains elusive. Furthermore, future studies need to use standardised diagnostic criteria for CCM as well as incorporate newer imaging techniques assessing both myocardial structure and function. Finally, while specific treatments are currently lacking, therapeutics targeting systemic inflammation, microbial dysbiosis and bacterial translocation are promising targets and warrant further research.
| Type: | Article |
|---|---|
| Title: | Cardiac dysfunction in patients with cirrhosis and acute decompensation |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/liv.15896 |
| Publisher version: | http://dx.doi.org/10.1111/liv.15896 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, cirrhotic cardiomyopathy, decompensated cirrhosis, CARDIOVASCULAR MAGNETIC-RESONANCE, MYOCARDIAL-CONTRACTILITY, NITRIC-OXIDE, SYSTEMIC INFLAMMATION, DIASTOLIC DYSFUNCTION, INTERVAL PROLONGATION, CARDIOMYOPATHY, HEMODYNAMICS, SURVIVAL, FAILURE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10192449 |
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