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CardioHepatology: Exploring the Interplay Between Cirrhosis, Cirrhotic Cardiomyopathy, Coronary Artery Disease, and
Claudia R Brick1, Benjamin Cailes2, Avik Majumdar3
1Department of Cardiology, Austin Health, Melbourne, Vic, Australia.
Insights
Cardiac comorbidities are common in cirrhosis patients, often missed. Early detection and management of cirrhotic cardiomyopathy are crucial for better outcomes, especially before liver transplantation.
Area of Science:
- Cardiology
- Hepatology
- Transplantation
Background:
- Cardiac comorbidities are prevalent and often overlooked in cirrhosis patients.
- Cirrhotic cardiomyopathy contributes to adverse cardiac and liver events, including hepatorenal syndrome.
- Metabolic dysfunction-associated steatotic liver disease and coronary artery disease present complex management challenges.
Purpose of the Study:
- To review the significant burden of cardiac disease in patients with cirrhosis.
- To emphasize the importance of cardiac assessment in liver transplant candidates.
- To highlight strategies for improving post-transplant cardiovascular outcomes.
Main Methods:
- Literature review focusing on cardiac disease in cirrhosis.
- Analysis of prevalence and impact of cardiac comorbidities.
- Evaluation of diagnostic and management strategies.
Main Results:
- Cardiac dysfunction (cirrhotic cardiomyopathy) is a key factor in adverse events.
- Under-recognition of cardiac issues is common in this population.
- Effective management can improve outcomes for liver transplant recipients.
Conclusions:
- Early identification and management of cardiac disease are vital in cirrhosis.
- Addressing cirrhotic cardiomyopathy is essential for patient survival and transplant success.
- Integrated care strategies are needed for patients with coexisting liver and cardiac conditions.
Abstract:
Cardiac comorbidities in patients with cirrhosis are common yet frequently under-recognised. Cirrhotic cardiomyopathy, a subclinical state of cardiac dysfunction, is emerging as a critical contributor to major adverse cardiac events in this patient population, as well as liver events such as hepatorenal syndrome. The increasing prevalence of patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease also poses significant management challenges for these patients. This review focuses on the considerable burden of cardiac disease in patients with cirrhosis, most notably in those undergoing assessment for liver transplantation. Our findings highlight the importance of early detection and the use of appropriate management strategies to enhance post-transplant cardiovascular outcomes.
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