Abstract
Cirrhotic cardiomyopathy (CCM) is a relatively new medical term. The constant development of novel diagnostic and clinical tools continuously delivers new data and findings about this broad disorder. The purpose of this review is to summarize current facts about CCM, identify gaps of knowledge, and indicate the direction in which to prepare an updated definition of CCM. We performed a review of the literature using scientific data sources with an emphasis on the latest findings. CCM is a clinical manifestation of disorders in the circulatory system in the course of portal hypertension. It is characterized by impaired left ventricular systolic and diastolic dysfunction, and electrophysiological abnormalities, especially QT interval prolongation. However, signs and symptoms reported by patients are non-specific and include reduced exercise tolerance, fatigue, peripheral oedema, and ascites. The disease usually remains asymptomatic with almost normal heart function, unless patients are exposed to stress or exertion. Unfortunately, due to the subclinical course, CCM is rarely recognized. Orthotopic liver transplantation (OLTx) seems to improve circulatory function although there is no consensus about its positive effect, with reported cases of heart failure onset after transplantation. Researchers indicate a careful pre-, peri-, and post-transplant cardiac assessment as a crucial point in detecting CCM and improving patients’ prognosis. There is also an urgent need to update the CCM definition and establish a diagnostic algorithm for early diagnosis of CCM as well as a specific treatment of this condition.
Highlights
We summarize the most important facts concerning cirrhotic cardiomyopathy and indicate the direction for further research
Cirrhotic cardiomyopathy is characterized by an impaired cardiac response to stress, which results from a combination of autonomic dysfunction, alterations in cell membrane composition, ion channel defects, and an overproduction of cardio depressant factors
The TnI serum level is often elevated in patients with alcoholic liver cirrhotic and corresponds to impaired systolic function, it is not related to an advanced stage of cirrhosis and portal hypertension [22]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Cirrhotic cardiomyopathy (CCM) is a relatively new medical term. It was first described in 2005 during the World Congress of Gastroenterology in Montreal as characteristic changes in the circulatory system in patients with alcoholic liver cirrhosis. Cirrhotic cardiomyopathy is a clinical manifestation of disorders in the circulatory system in the course of portal hypertension. It is characterized by impaired left ventricular systolic and diastolic dysfunction and electrophysiological abnormalities, especially QT interval prolongation. Decompensation of the circulatory system may occur during liver transplantation, which is responsible for increased perioperative mortality due to cardiovascular causes [3,4]. We summarize the most important facts concerning cirrhotic cardiomyopathy and indicate the direction for further research
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