Cirrhotic cardiomyopathy and its relationship with liver cirrhosis
Keywords:
Liver cirrhosis, cirrhotic cardiomyopathy, diastolic dysfunction, systolic dysfunctionAbstract
Introduction: Cirrhotic cardiomyopathy is an underestimated cardiovascular complication in patients with advanced liver cirrhosis. Its clinical recognition is limited due to its silent presentation and the lack of standardized diagnostic criteria.
Objective: To review the pathophysiological mechanisms, clinical manifestations, diagnosis, and epidemiology of cirrhotic cardiomyopathy, highlighting its impact on morbidity and mortality in patients with cirrhosis.
Material and Methods: A narrative review of the scientific literature was conducted, consulting databases such as PubMed, LILACS, Hinari, and Google Scholar. Thirty-four articles published between 2020 and 2025 were selected, prioritizing systematic reviews, original studies, and full-text articles relevant to the study objectives.
Results: Cirrhotic cardiomyopathy is characterized by diastolic and systolic dysfunction, abnormal stress response, and electrophysiological abnormalities, in the absence of evident structural heart disease. Its pathophysiology involves sympathetic hyperactivity, autonomic dysfunction, systemic inflammation, oxidative stress, and hormonal alterations. Its estimated prevalence ranges between 40% and 70% in patients with advanced cirrhosis, especially in liver transplant candidates. The diagnosis is based on echocardiography, biomarkers, and functional testing, although inconsistencies persist among the criteria used in clinical practice.
Conclusion: Cirrhotic cardiomyopathy represents a diagnostic challenge with significant prognostic implications. Its timely identification and comprehensive evaluation can improve clinical outcomes, particularly in the context of liver transplantation. Greater diagnostic standardization and clinical validation of new criteria are required.
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