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Physiopathological and diagnostic aspects of cirrhotic cardiomyopathy

Talia M Leal-Alvarado1, Ignacio Escalante-Sandoval2, José L Gálvez-Romero3

  • 1Echocardiographic Cardiology, Hospital Regional ISSSTE Puebla. Puebla, Mexico.

Archivos De Cardiologia De Mexico
|September 8, 2020
PubMed

Insights

Cirrhotic cardiomyopathy involves heart problems in liver cirrhosis patients. Early detection using echocardiography, including longitudinal strain, is crucial for better patient outcomes.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Cirrhotic cardiomyopathy (CC) presents cardiac structural and functional changes in liver cirrhosis patients.
  • It's linked to poor treatment response in portal hypertension and worse transplant outcomes.
  • Despite being known since 1953, CC is underdiagnosed and poorly understood.

Purpose of the Study:

  • To highlight the characteristics and diagnostic approaches for cirrhotic cardiomyopathy.
  • To emphasize the clinical significance and underdiagnosis of this condition.
  • To discuss the role of echocardiography and emerging techniques in CC detection.

Main Methods:

  • Review of clinical characteristics of cirrhotic cardiomyopathy.
  • Discussion of diagnostic utility of echocardiography, including E/A index and ejection fraction.
  • Exploration of advanced techniques like longitudinal strain for early detection.

Main Results:

  • CC involves diastolic and systolic dysfunction, electrical conduction abnormalities (QTc prolongation), and blunted chronotropic response.
  • Echocardiography, particularly the E/A index, is a practical diagnostic tool.
  • Pharmacological stress echocardiography aids in detecting latent forms of systolic dysfunction.

Conclusions:

  • Cirrhotic cardiomyopathy is an underdiagnosed complication of liver cirrhosis with significant clinical implications.
  • Echocardiography is key for diagnosis, with longitudinal strain showing promise for early detection.
  • Improved recognition and diagnostic strategies are needed for better patient management and outcomes.

Keywords:
Cirrhotic cardiomyopathyCirrosis hepáticaDiastolic dysfunctionDisfunción diastólicaDisfunción sistólicaHepatic cirrhosisMiocardiopatía cirróticaOrthotopic liver transplantStrainSystolic dysfunctionTrasplante hepático ortotópico

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