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Liver in cardiopulmonary disease
Naveen Polavarapu1, Dhiraj Tripathi
1Liver Unit, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham B15 2TH, UK.
Best Practice & Research. Clinical Gastroenterology
|October 5, 2013
Summary
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PoPH) are complex lung conditions in cirrhosis patients. Liver transplantation is the primary treatment, but outcomes vary.
Area of Science:
- Cardiology
- Pulmonology
- Hepatology
Background:
- Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PoPH) are pulmonary vascular complications in cirrhotic patients.
- HPS involves pulmonary vasodilation leading to hypoxemia, while PoPH features vasoconstriction and increased pulmonary vascular resistance.
- These conditions can coexist, with PoPH often developing in patients with pre-existing HPS.
Purpose of the Study:
- To review the understanding of hepatopulmonary syndrome and portopulmonary hypertension in cirrhotic patients.
- To discuss the relationship between these conditions and cirrhotic cardiomyopathy.
- To highlight current treatment limitations and outcomes.
Main Methods:
- Literature review of pulmonary vascular conditions in cirrhosis.
- Analysis of the pathophysiology of HPS and PoPH.
- Discussion of cirrhotic cardiomyopathy and its impact.
Main Results:
- HPS is more common than PoPH, characterized by vasodilation and hypoxemia.
- PoPH involves vasoconstriction and vascular remodeling, increasing pulmonary resistance.
- Cirrhotic cardiomyopathy presents with impaired cardiac stress response.
Conclusions:
- Treatment options for HPS and PoPH are limited, primarily liver transplantation.
- Outcomes following liver transplantation for these conditions are variable.
- Effective therapies for cirrhotic cardiomyopathy are lacking.
Keywords:
Cirrhotic cardiomyopathyDiastolic dysfunctionHepatopulmonary syndromePortal hypertensionPortopulmonary hypertensionPulmonary hypertensionMore Related Videos
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