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Related Concept Videos

Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Cirrhosis II: Pathophysiology01:24

Cirrhosis II: Pathophysiology

Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to structural...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...

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Related Experiment Video

Updated: Jun 30, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Advanced Cirrhosis Is Independently Associated With Increased In-Hospital Mortality in Heart Failure With Reduced

Teddy A Teddy1, Edidiong Okon-Ben1, Fraol T Erega2

  • 1Internal Medicine, Detroit Medical Center/Wayne State University, Detroit, USA.

Cureus
|June 29, 2026
PubMed
Summary

Advanced cirrhosis significantly increases in-hospital mortality risk for patients with heart failure with reduced ejection fraction (HFrEF). This association is independent and dose-dependent, highlighting the need for integrated care.

Keywords:
advanced cirrhosiscardio‑hepatic interactiondecompensated cirrhosisheart failure with reduced ejection fraction (hfref)in‑hospital mortalitymultimorbidityrisk adjustment

Related Experiment Videos

Last Updated: Jun 30, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Advanced cirrhosis presents systemic hemodynamic changes potentially worsening outcomes in heart failure with reduced ejection fraction (HFrEF) patients.
  • Limited national data exists on the independent association between advanced cirrhosis and in-hospital mortality in HFrEF.
  • Cirrhosis decompensation features include ascites, hepatic encephalopathy, portal hypertension, variceal bleeding, or hepatorenal syndrome.

Purpose of the Study:

  • To estimate the independent association between advanced cirrhosis and in-hospital mortality among HFrEF hospitalizations.
  • To analyze national-level data for this specific high-risk patient population.

Main Methods:

  • Retrospective cross-sectional analysis using the 2022 National Inpatient Sample (NIS).
  • Inclusion criteria: Adults hospitalized with primary diagnosis of HFrEF (ICD 10 I50.22).
  • Advanced cirrhosis defined by at least one decompensating feature; multivariable logistic regression adjusted for confounders.

Main Results:

  • 2.1% of 254,571 HFrEF hospitalizations had advanced cirrhosis.
  • Advanced cirrhosis patients were younger and more male (p<0.001).
  • In-hospital mortality was higher in the advanced cirrhosis group (9.7% vs 3.8%, p<0.001), independently associated with increased mortality (aOR: 2.18; p<0.001).

Conclusions:

  • Advanced cirrhosis is independently linked to over double the odds of in-hospital death in HFrEF patients.
  • The association is consistent across subgroups and shows a dose-response relationship with cirrhosis severity.
  • Multidisciplinary management involving cardiology, hepatology, and critical care is recommended; prospective studies are needed.