John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Cirrhotic cardiomyopathy: New diagnostic approaches Volume 28, issue 5, Mai 2021


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1 Montlégia, Service de cardiologie, Liège, Belgique
2 CHU de Caen, Service d’hépatologie, Caen
3 Hôpital Jean-Minjoz, Service d’hépatologie et de soins intensifs digestifs, 25000 Besançon
4 Hôpital Jean-Minjoz, Service de cardiologie, 25000 Besançon
5 Université de Liège, Belgique
* Correspondance

Cirrhotic cardiomyopathy (CCM) is a cardiac dysfunction combining structural, functional (systolic and/or diastolic) and electrophysiological abnormalities in cirrhotic patients without primary cardiac disease. Its prevalence is high (around 50%) and manifests overtly when the cardiovascular system is challenged (sepsis, surgery). Its pathophysiology is complex and related to the severity of portal hypertension and the subsequent systemic inflammation. CCM is associated with an increase in myocardial extracellular volume, mainly due to an increase in myocardial fibrosis detectable on cardiac MRI. The diagnostic criteria for CCM were revised in 2019, trying to incorporate significant advancements in cardiovascular imaging, and combine new parameters for the evaluation of diastolic function reviewed in 2016. There is no specific treatment for CCM but liver transplantation remains the more effective treatment for patients with end-stage liver disease associated with CCM.