Review
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World J Hepatol. Jan 27, 2014; 6(1): 41-54
Published online Jan 27, 2014. doi: 10.4254/wjh.v6.i1.41
Hepato-cardiac disorders
Yasser Mahrous Fouad, Reem Yehia
Yasser Mahrous Fouad, Reem Yehia, Gastroenterology and Hepatology Unit, Endemic Medicine Department, Minia University, Minia 19111, Egypt
Author contributions: Fouad YM and Yehia R contributed equally to this work; Both authors collected the data, every author wrote a part of the manuscript and both authors revised the manuscript.
Correspondence to: Yasser Mahrous Fouad, MD, Do, Professor, Gastroenterology and Hepatology Unit, Endemic Medicine Department, Minia University, Damaris, Minia 19111, Egypt. yasserfouad10@yahoo.com
Telephone: +20-11-14721500 Fax: +20-11-867827922
Received: October 22, 2013
Revised: November 19, 2013
Accepted: January 6, 2014
Published online: January 27, 2014
Abstract

Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

Keywords: Cardiac cirrhosis, Ischemic hepatitis, Fatty liver, Liver cirrhosis, Heart failure

Core tip: Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to improvement of all cardiac changes and reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both liver and heart concomitantly including congenital, metabolic, inflammatory diseases and alcoholism.