Cardiovascular dysfunction in patients with end-stage liver disease.
Most patients with advanced liver disease have a normal or even supernormal ejection fraction judged by echocardiography. Thus, physicians previously assumed that cardiac function was normal in most patients with liver disease. However, further investigation has uncovered multiple problems in cardiac performance that place patients at risk of heart failure. Patients with liver disease have defects in both systolic and diastolic function that only become obvious with physiologic stress such as liver transplantation. In addition there are additional defects in the electromechanical coupling of the heart that can have significant clinical consequences. These collective pathologic changes are termed "cirrhotic cardiomyopathy" and occur to some degree in all patients with liver disease. This review will explore the pathophysiology of cardiovascular changes in patients with end-stage liver disease.
Mandell
Merceds Susan
MS
Department of Anesthesiology, University of Colorado Health Sciences Center, Aurora, Colorado, USA.
Tsou
Mei-Yung
MY
D002318:Cardiovascular Diseases / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*