Zirrhotische Kardiomyopathie

Die zirrhotische Kardiomyopathie ist eine häufige Komplikation bei Patienten mit fortgeschrittener Lebererkrankung. Da sie im Ruhezustand meist inapparent ist und erst durch eine inadäquate kardiale Reaktion auf hämodynamische Belastungssituationen demaskiert wird, ist die Diagnose oftmals schwierig. Der vorliegende Beitrag bietet eine Übersicht über zugrunde liegende pathophysiologische Mechanismen und die neuen modifizierten Diagnosekriterien.

Abstract

A cirrhotic cardiomyopathy (CCM) can be observed in patients with end-stage liver disease and is characterized by a systolic and/or diastolic dysfunction in the absence of pre-existing heart diseases. While the cardiac dysfunction is often masked at rest, it typically manifests itself during cardiovascular challenges such as hypovolemia, physical stress, or sepsis. The diagnosis of CCM is challenging and predominantly based on echocardiographic measurements to identify subclinical cardiac dysfunction. Additional diagnostic criteria include electrophysiological abnormalities such as QT-interval prolongation, an abnormal chronotropic or inotropic response to stress, elevated cardiac biomarkers such as natriuretic peptides, and structural cardiac abnormalities like left atrium enlargement. There is no specific therapy for CCM. Supportive measures and regular cardiac evaluation of high-risk patients and transplant candidates are important to reduce the risks associated with invasive procedures and treatments.

Schlüsselwörter

zirrhotische Kardiomyopathie - Leberzirrhose - diastolische Dysfunktion - systolische Dysfunktion

Key words

cirrhotic cardiomyopathy - liver cirrhosis - diastolic dysfunction - systolic dysfunction

Publication History

Article published online:
20 August 2021

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