Cardiohepatic syndrome: liver injury in decompensated heart failure

Heart failure (HF) is a major healthcare concern. Acute HF carries a high mortality and a high rehospitalisation rate. HF has a variety of detrimental effects on other organs. In recent years, the interactions between heart failure and the kidney have been the subject of significant investigations; this interaction, defined as "cardiorenal syndrome", is relatively well characterized. We describe here another interaction between the heart and the liver, the "cardiohepatic syndrome", in acute HF patients. Recent publications have shown that liver function test (LFT) abnormalities were associated with AHF severity. Clinical signs of systemic congestion were found to be associated with cholestasis, when signs of hypoperfusion were associated with liver cytolysis. Defining the LFT profile in AHF may play an important role in the future management of AHF patients.