Does cirrhotic cardiomyopathy exist? 50 years of uncertainty
Pierpaolo Pellicori1, Concetta Torromeo, Angela Calicchia
1Department of Academic Cardiology, Hull and East Yorkshire Medical Research and Teaching Centre MRTDS (Daisy) Building, Entrance 2 Castle Hill Hospital, Cottingham, Kingston upon Hull, HU16 5JQ, UK, p.pel@libero.it.
Insights
Diagnosing cirrhotic cardiomyopathy, abnormal heart function in liver cirrhosis patients, is challenging due to a lack of clear definition and confounding factors. Early detection may be possible with new imaging and biomarkers.
Area of Science:
- Cardiology
- Hepatology
- Internal Medicine
Background:
- Subtle cardiac abnormalities, termed cirrhotic cardiomyopathy, are common in liver cirrhosis patients.
- Diagnosis is challenging due to the absence of a precise definition and confounding factors.
- Cardiac dysfunction can be masked by treatments or co-existing conditions like anemia.
Purpose of the Study:
- To highlight the diagnostic challenges of cirrhotic cardiomyopathy.
- To emphasize the need for research into the specific causes and significance of liver disease-related cardiac dysfunction.
- To explore potential early detection methods.
Main Methods:
- Literature review and synthesis of current understanding regarding cirrhotic cardiomyopathy.
- Analysis of factors complicating the diagnosis of cardiac dysfunction in cirrhosis.
- Discussion of emerging diagnostic technologies.
Main Results:
- Cirrhotic cardiomyopathy lacks a standardized definition, complicating diagnosis.
- Concomitant diseases (hypertension, ischemic heart disease, alcohol use) and treatments (mineral-corticoid receptor antagonists) can obscure cardiac dysfunction.
- Anemia can also mask cardiac abnormalities.
Conclusions:
- Further research is essential to define cirrhotic cardiomyopathy and its origins.
- New imaging tests and plasma biomarkers show promise for early detection of cardiac dysfunction in liver cirrhosis.
- Accurate diagnosis is crucial for appropriate patient management.
Abstract:
Subtle abnormalities of cardiac structure or function are often identified in patients with liver cirrhosis and have been termed cirrhotic cardiomyopathy. However, in the absence of a precise definition, its diagnosis remains a challenge. Cardiac dysfunction in patients with cirrhosis can often be attributed to concomitant diseases such as hypertension, ischaemic heart disease or excess alcohol consumption in many patients. Further research is required to identify the existence, origin and importance of abnormal cardiac function due specifically to liver disease. Cardiac dysfunction may be masked by treatments given to cirrhotic patients, such as mineral-corticoid receptor antagonists, or by co-existing conditions, such as anaemia. New imaging tests or plasma biomarkers might be able to detect abnormal cardiac function at an early stage of its development.
Related Concept Videos
Cardiomyopathy I: Introduction and Classification
Cirrhosis I: Introduction
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Cardiomyopathy IV: Restrictive Cardiomyopathy
Cardiomyopathy II: Dilated Cardiomyopathy
Cardiomyopathy V: Interprofessional Care

