Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 331-335, July 2008

Cardiovascular Dysfunction in Patients with End-stage Liver Disease

  • Merceds Susan Mandell

      Affiliations

    • Department of Anesthesiology, University of Colorado Health Sciences Center, Aurora, Colorado, U.S.A.
    • ,
  • Mei-Yung Tsou

      Affiliations

    • Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Mei-Yung Tsou, Department of Anesthesiology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C

Received 27 December 2007; accepted 24 April 2008.

Article Outline

Most patients with advanced liver disease have a normal or even supernormal ejection fraction judged by echocardiogra-phy. Thus, physicians previously assumed that cardiac function was normal in most patients with liver disease. However, further investigation has uncovered multiple problems in cardiac performance that place patients at risk of heart failure. Patients with liver disease have defects in both systolic and diastolic function that only become obvious with physiologic stress such as liver transplantation. In addition there are additional defects in the electromechanical coupling of the heart that can have significant clinical consequences. These collective pathologic changes are termed “cirrhotic cardiomyopathy” and occur to some degree in all patients with liver disease. This review will explore the pathophysiology of cardiovascular changes in patients with end-stage liver disease.

Key Words:  cardiac function , cardiomyopathy , liver transplantation

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PII: S1726-4901(08)70134-5

doi:10.1016/S1726-4901(08)70134-5

Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 331-335, July 2008

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