Open AccessCardiovascular changes in cirrhosis: Pathogenesis and clinical implications
Author(s) -
Waleed Al–Hamoudi
Publication year - 2010
Publication title -
the saudi journal of gastroenterology/saudi journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 32
eISSN - 1998-4049
pISSN - 1319-3767
DOI - 10.4103/1319-3767.65181
Subject(s) - medicine , hyperdynamic circulation , spontaneous bacterial peritonitis , cirrhosis , hepatopulmonary syndrome , hepatorenal syndrome , pathogenesis , liver transplantation , portal hypertension , ascites , transplantation , gastroenterology , cardiology , intensive care medicine
Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyperdynamic circulation, cirrhotic cardiomyopathy, and pulmonary vascular abnormalities. The pathogenic mechanisms of these cardiovascular changes are multifactorial and include neurohumoral and vascular dysregulations. Accumulating evidence suggests that cirrhosis-related cardiovascular abnormalities play a major role in the pathogenesis of multiple life-threatening complications including hepatorenal syndrome, ascites, spontaneous bacterial peritonitis, gastroesophageal varices, and hepatopulmonary syndrome. Treatment targeting the circulatory dysfunction in these patients may improve the short-term prognosis while awaiting liver transplantation. Careful fluid management in the immediate post-transplant period is extremely important to avoid cardiac-related complications. Liver transplantation results in correction of portal hypertension and reversal of all the pathophysiological mechanisms that lead to the cardiovascular abnormalities, resulting in restoration of a normal circulation. The following is a review of the pathogenesis and clinical implications of the cardiovascular changes in cirrhosis.