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Updated: Jun 23, 2026
Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
Cardiovascular complications of cirrhosis
1Department of Clinical Physiology, 239, Hvidovre Hospital, DK-2650 Copenhagen, Denmark. soeren.moeller@hvh.regionh.dk
Insights
Cirrhosis causes cardiovascular issues like cirrhotic cardiomyopathy, affecting heart function. These latent conditions require careful management during medical procedures and highlight the need for further research into effective treatments.
Area of Science:
- Cardiology
- Hepatology
- Internal Medicine
Background:
- Cirrhosis presents with complex cardiovascular complications, including hemodynamic alterations and cardiac dysfunction.
- Cirrhotic cardiomyopathy, distinct from alcoholic heart disease, involves systolic/diastolic dysfunction and electrophysiological changes.
- These cardiac issues are often latent and exacerbated by physiological stress.
Purpose of the Study:
- To review the cardiovascular complications associated with cirrhosis.
- To describe cirrhotic cardiomyopathy and its clinical implications.
- To discuss management strategies and future research directions.
Main Methods:
- Literature review of cardiovascular complications in cirrhosis.
- Analysis of the pathophysiology of cirrhotic cardiomyopathy.
- Discussion of clinical management and treatment considerations.
Main Results:
- Cardiovascular complications encompass central, splanchnic, and peripheral circulatory abnormalities.
- Cirrhotic cardiomyopathy manifests as latent cardiac dysfunction, unmasked by stress.
- Cardiac failure is a significant mortality factor post-liver transplantation, though improved liver function can reverse cardiac issues.
Conclusions:
- Cardiovascular complications and cirrhotic cardiomyopathy are critical aspects of cirrhosis management.
- Caution is advised during invasive procedures due to the risk of unmasking latent cardiac dysfunction.
- Further research and randomized trials are essential to develop specific treatments for these complications.
Abstract:
Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis without adequate plasma volume expansion, transjugular intrahepatic portosystemic shunt (TIPS) insertion, peritoneovenous shunting and surgery. Cardiac failure is an important cause of mortality after liver transplantation, but improved liver function has also been shown to reverse the cardiac abnormalities. No specific treatment can be recommended, and cardiac failure should be treated as in non-cirrhotic patients with sodium restriction, diuretics, and oxygen therapy when necessary. Special care should be taken with the use of ACE inhibitors and angiotensin antagonists in these patients. The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.
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