Cirrhotic cardiomyopathy: pathophysiology, clinical course and treatment
At present the pathogenesis, diagnostic criteria and therapeutic principles in treatment of cirrhotic cardiomyopathy are not adequately studied. Increase of cardiac output due to hyperdynamic circulation is considered to be the major pathophysiologic sign of the disease. The main clinical signs of cirrhotic cardiomyopathy are inadequate increase of cardiac output as a response to provocative factors, diastolic dysfunction, electric and physiologic anomalies of conduction and chronotropic insufficiency. This review will focus on pathophysiologic and clinical features of cirrhotic cardiomyopathy, discussing the main therapeutic approaches, as well as the influence of orthotopic transplantation and transjugular portosystemic shunt on the course and prognosis of cardio-vascular disorders in liver cirrhosis.