Heart failure in a patient with cirrhotic cardiomyopathy as an unusual indication for liver transplantation

Czech version

Authors: Pavlíková P.
Authors‘ workplace: Klinika hepatogastroenterologie, Transplantcentrum, IKEM, Praha
Published in: Gastroent Hepatol 2020; 74(5): 424-427
Category: Hepatology: Case Report

Overview

Cirrhotic cardiomyopathy is a heart disease that may develop in patients with significant portal hypertension and concomitant hyperdynamic circulation. It is a rare complication in which the diagnosis is difficult and the prognosis is not clear. We present a case of female patient with liver cirrhosis who underwent liver transplantation in 2017 due to repeated heart failure in cirrhotic cardiomyopathy. Before being indicated for liver transplantation, the patient had to be repeatedly and very carefully examined by cardiologist to rule out other primary heart disease. The post-transplantation course was favourable in this patient with good synthetic function of the liver graft. The cardiac status returned to a normal state after 6 months.

Keywords:

cardiomyopathies – liver cirrhosis – portal hypertension – liver transplantation

Sources

1. Iwakiri Y, Groszmann RJ. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule. Hepatology 2006; 43 (2 Suppl 1): S121–S131. doi: 10.1002/hep. 20993.

2. Lee SS. Cardiac abnormalities in liver cirrhosis. West J Med 1989; 151 (5): 530–535.

3. Bolognesi M, Di Pascoli M, Verardo A et al. Splanchnic vasodilation and hyperdynamic circulatory syndrome in cirrhosis. World J Gastroenterol 2014; 20 (10): 2555–2563. doi: 10.3748/wjg.v20.i10.2555.

4. Møller S, Henriksen JH. Cirrhotic cardiomyopathy. J Hepatol 2010; 53 (1): 179–190. doi: 10.1016/j.jhep.2010.02.023.

5. Ruíz-del-Árbol L, Achécar L, Serradilla R et al. Diastolic dysfunction is a predictor of poor outcomes in patients with cirrhosis, portal hypertension, and a normal creatinine. Hepatology 2013; 58 (5): 1732–1741. doi: 10.1002/hep.26509.

6. Pozzi M, Carugo S, Boari G et al. Evidence of functional and structural cardiac abnormalities in cirrhotic patients with and without ascites. Hepatology 1997; 26 (5): 1131–1137. doi: 10.1002/hep.510260507.

7. Liu H, Jayakumar S, Traboulsi M et al. Cirrhotic cardiomyopathy: implications for liver transplantation. Liver Transpl 2017; 23 (6): 826–835. doi: 10.1002/lt.24768.

8. Dowsley TF, Bayne DB, Langnas AN et al. Diastolic dysfunction in patients with end-stage liver disease is associated with development of heart failure early after liver transplantation. Transplantation 2012; 94 (6): 646–651. doi: 10.1097/TP.0b013e31825f0 f97.

9. Torregrosa M, Aguadé S, Dos L et al. Cardiac alterations in cirrhosis: reversibility after liver transplantation. J Hepatol 2005; 42 (1): 68–74. doi: 10.1016/j.jhep.2004.09.008.

10. Hadengue A, Lebrec D, Moreau R et al. Persistence of systemic and splanchnic hyperkinetic circulation in liver transplant patients. Hepatology 1993; 17 (2): 175–178.