Acute cardiac liver injury and levosimendan


Authors: MUDr. Ondřej Ludka;  Ph.D. 1,2;  MUDr. Jiří Hlásenský 1;  prof. MUDr. Jindřich Špinar, CSc.;  Fesc 1,2
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno 1;  Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně 2
Published in: Kardiol Rev Int Med 2013, 15(4): 234-237
Category:

Overview

Heart failure is the major public health problem of the 21st century, with frequent re-hospitalizations, impaired quality of life and prognosis. The progression of heart failure is often characterized by an increasing inability of the heart to meet the metabolic demands of most organs. While the consequences of acute heart failure on renal function have been described many times, a comprehensive description of the impact of acute heart failure on the liver function is still lacking. In the treatment of acute heart failure, we can exploit the hepatoprotective effect of levosimendan, which is probably due to its favorable hemodynamic effects, specifically because of its positive inotropic and vasodilatory effects, together with a direct hepatocytic effect, accompanied by an increase in metabolic and adaptation reserves of hepatocytes.

Keywords:
levosimendan – cardiohepatic failure – acute cardiac liver injury


Sources

1. Smith GL, Lichtman JH, Bracken MB et al. Renal impairment and outcomes in heart failure: systematic review and meta-analysis. J Am Coll Cardiol 2006; 47: 1987–1996.

2. Yilmaz MB, Grossini E, Silva Cardoso JC et al. Renal effects of levosimendan: a consensus report. Cardiovasc Drugs Ther 2013; 27: 581–590.

3. Zemljic G, Bunc M, Yazdanbakhsh AP et al. Levosimendan improves renal function in patients with advanced chronic heart failure awaiting cardiac transplantation. J Card Fail 2007; 13: 417–421.

4. Henrion J. Hypoxic hepatitis. Liver Int 2012; 32: 1039–52.

5. Henrion J, Schapira M, Luwaert R et al. Hypoxic hepatitis: clinical and hemodynamic study in 142 consecutive cases. Medicine (Baltimore) 2003; 82: 392–406.

6. Seeto RK, Fenn B, Rockey DC. Ischemic hepatitis: clinical presentation and pathogenesis. Am J Med 2000; 109: 109–113.

7. Henrion J, Descamps O, Luwaert R et al. Hypoxic hepatitis in patients with cardiac failure: incidence in a coronary care unit and measurement of hepatic blood flow. J Hepatol 1994; 21: 696–703.

8. Giallourakis CC, Rosenberg PM, Friedman LS. The liver in heart failure. Clin Liver Dis 2002; 6: 947–967.

9. Boland EW, Willius FA. Changes in the liver produced by chronic passive congestion: with special reference to the problem of cardiac cirrhosis. Arch Intern Med 1938; 62: 723–739.

10. Fuhrmann V, Kneidinger N, Herkner H et al. Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients. Intensive Care Med 2009; 35: 1397–1405.

11. Raurich JM, Llompart-Pou JA, Ferreruela M et al. Hypoxic hepatitis in critically ill patients: incidence, etiology and risk factors for mortality. J Anesth 2011; 25: 50–56.

12. Nikolaou M, Parissis J, Yilmaz MB et al. Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure. Eur Heart J 2013; 34: 742–749.

13. Naschitz JE, Slobodin G, Lewis RJ et al. Heart diseases affecting the liver and liver diseases affecting the heart. Am Heart J 2000; 140: 111–120.

14. Cassidy WM, Reynolds TB. Serum lactic dehydrogenase in the differential diagnosis of acute hepatocellular injury. J Clin Gastroenterol 1994; 19: 118–121.

15. Ruttmann E, Brant LJ, Concin H et al. Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163, 944 Austrian adults. Circulation 2005; 112: 2130–2137.

16. Szyguła-Jurkiewicz B, Wojnicz R, Lekstron A et al. Effect of elevated bilirubin levels on the long-term outcome in patients with chronic heart failure due to hypertension. Pol Arch Med Wewn 2007; 117: 227–233.

17. Mebazaa A, Nieminen MS, Packer M et al. Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE randomized trial. JAMA 2007; 297: 1883–1891.

18. Sherlock S. The liver in heart failure; relation of anatomical, functional, and circulatory changes. Br Heart J 1951; 13: 273–293.

19. Kalambokis G, Manousou P, Vibhakorn S et al. Transjugular liver biopsy – indications, adequacy, quality of specimens, and complications – a systematic review. J Hepatol 2007; 47: 284–294.

20. Naschitz JE, Yeshurun D, Shahar J. Cardiogenic hepatorenal syndrome. Angiology 1990; 41: 893–900.

21. Hickman PE, Potter JM. Mortality associated with ischaemic hepatitis. Aust N Z J Med 1990; 20: 32–34.

22. Hepner GW, Vesell ES, Tantum KR. Reduced drug elimination in congestive heart failure. Studies using aminopyrine as a model drug. Am J Med 1978; 65: 371–376.

23. White TJ, Leevy CM, Brusca AM et al. The liver in congestive heart failure. Am Heart J 1955; 49: 250–257.

24. Bjerkelund CJ, Gleditsch E. Hypoprothrombinemia; occurrence and prognostic significance in congestive heart failure. Acta Med Scand 1953; 145: 181–188.

25. Kisloff B, Schaffer G. Fulminant hepatic failure secondary to congestive heart failure. Am J Dig Dis 1976; 21: 895–900.

26. Málek F, Ošťádal P, Krüger A et al. Levosimendan a renální funkce. Kardiol Rev 2013; 15: 178–180.

27. Vojáček J a Kettner J et al. Klinická kardiologie. Praha: Nucleus HK 2012.

28. Puttonen J, Kantele S, Ruck A et al. Pharmacokinetics of intravenous levosimendan and its metabolites in subjects with hepatic impairment. J Clin Pharmacol 2008; 48: 445–454.

29. Nieminen MS, Akkila J, Hasenfuss G et al. Hemodynamic and neurohumoral effects of continuous infusion of levosimendan in patients with congestive heart failure. J Am Coll Cardiol 2000; 36: 1903–1912.

30. Slawsky MT, Colucci WS, Gottlieb SS et al. Acute hemodynamic and clinical effects of levosimendan in patients with severe heart failure. Circulation 2000; 102: 2222–2227.

31. Follath F, Cleland JG, Just H et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet 2002; 360: 196–202.

32. Onody P, Stangl R, Fulop A et al. Levosimendan: a cardiovascular drug to prevent liver ischemia-reperfusion injury? PLoS One 2013; 8: e73758.

Labels
Paediatric cardiology Cardiac surgery Cardiology
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account