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Int J Angiol 2011; 20(3): 135-142
DOI: 10.1055/s-0031-1284434
REVIEW ARTICLE

© Thieme Medical Publishers

Liver Abnormalities in Cardiac Diseases and Heart Failure

Alicia M. Alvarez1 , Debabrata Mukherjee1
  • 1Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX
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Publication History

Publication Date:
19 July 2011 (online)

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ABSTRACT

Heart failure (HF) is characterized by the inability of systemic perfusion to meet the body's metabolic demands and is usually caused by cardiac pump dysfunction and may occasionally present with symptoms of a noncardiac disorder such as hepatic dysfunction. The primary pathophysiology involved in hepatic dysfunction from HF is either passive congestion from increased filling pressures or low cardiac output and the consequences of impaired perfusion. Passive hepatic congestion due to increased central venous pressure may cause elevations of liver enzymes and both direct and indirect serum bilirubin. Impaired perfusion from decreased cardiac output may be associated with acute hepatocellular necrosis with marked elevations in serum aminotransferases. Cardiogenic ischemic hepatitis (“shock liver”) may ensue following an episode of profound hypotension in patients with acute HF. We discuss pathophysiology and identification of liver abnormalities that are commonly seen in patients with HF.

KEYWORDS

Heart failure - liver dysfunction - cardiovascular disease - pulsatile liver - hepatic congestion - shock liver - cardiac output

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Debabrata MukherjeeM.D. F.A.C.C. 

Texas Tech University, 4800 Alberta Avenue

El Paso, TX 79905

Email: debabrata.mukherjee@ttuhsc.edu

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