Related Experiment Video

Updated: Jun 16, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
09:37

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats

Published on: August 1, 2018

Abnormal liver function in relation to hemodynamic profile in heart failure patients

V M van Deursen1, K Damman, H L Hillege

  • 1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Journal of Cardiac Failure
|February 4, 2010
PubMed

Insights

Abnormal liver function tests in heart failure (HF) patients primarily indicate elevated central venous pressure (CVP). Specific tests like AST, ALT, and total bilirubin may also signal low cardiac index (CI), reflecting poor hemodynamic status.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Heart failure (HF) is often associated with secondary organ dysfunction.
  • Liver function abnormalities are common in HF patients and may reflect disease severity.

Purpose of the Study:

  • To investigate the relationship between liver function test (LFT) abnormalities and hemodynamic parameters in patients with heart failure.
  • To determine the prognostic value of LFTs in relation to central venous pressure (CVP) and cardiac index (CI).

Main Methods:

  • Studied 323 heart failure patients.
  • Assessed liver function using AST, ALT, alkaline phosphatase, GGT, LDH, and bilirubin.
  • Measured CVP and CI invasively; followed patients for all-cause mortality.

Main Results:

  • All LFTs correlated with CVP; GGT and direct bilirubin showed the strongest association with higher CVP.
  • Elevated AST, ALT, and total bilirubin were linked to both low CI and elevated CVP.
  • Prognostic value of LFTs depended on their interaction with CI and CVP.

Conclusions:

  • Elevated LFTs in HF mainly reflect increased CVP.
  • Specific LFTs (AST, ALT, direct bilirubin) may indicate a low CI.
  • Abnormal LFTs in HF signify a compromised hemodynamic status, especially when invasive measurements are available.
Abstract

Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug01:14

Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug

In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...