title: Pathophysiological and clinical approach to cirrhotic cardiomyopathy.
abstract: Hyperdynamic circulation, systolic and diastolic left ventricular dysfunction and certain electrophysiological abnormalities have been associated with cirrhosis and known for a long time. These clinical features have been introduced as cirrhotic cardiomyopathy (CCM), which is characterized by blunted myocardial contractile responsiveness to physical, physiological and pharmacological stress. Importantly, cardiac dysfunction can be reversible and can improve due to effective medical treatment and also after liver transplantation. Echocardiography and electrocardiography are essential tools for recognizing the characteristic changes in the myocardial function and also the alterations in the electrophysiological properties of the heart. Laboratory markers are auxiliary modalities further aiding the establishment of the correct diagnosis. In this review, we aimed to collect the pathophysiological background and clinical characteristics of CCM with the intention of summarizing the current possibilities for the diagnosis establishment and treatment of this cardio-hepatic disorder.
authors.affiliation: University of Debrecen Clinical Center, Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary.
authors.forename: Alida
authors.initials: A
authors.lastname: Páll
authors.affiliation: University of Debrecen Clinical Center, Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary.
authors.forename: Arpád
authors.initials: A
authors.lastname: Czifra
authors.affiliation: University of Debrecen Clinical Center, Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Vitális
authors.affiliation: University of Debrecen Clinical Center, Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary. papp.maria@med.unideb.hu.
authors.forename: Mária
authors.initials: M
authors.lastname: Papp
authors.affiliation: University of Debrecen Clinical Center, Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Paragh
authors.affiliation: University of Debrecen Clinical Center , Institute of Medicine, Department of Gastroenterology, Debrecen, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szabó
mesh_terms: D000200:Action Potentials; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left