Semin Liver Dis 2008; 28(1): 059-069
DOI: 10.1055/s-2008-1040321
© Thieme Medical Publishers

Cirrhotic Cardiomyopathy

Saleh A. Alqahtani1 , Tamer R. Fouad2 , Samuel S. Lee2
  • 1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • 2Liver Unit, University of Calgary, Calgary, Alberta, Canada
Further Information

Publication History

Publication Date:
22 February 2008 (online)


Liver cirrhosis is associated with several cardiovascular abnormalities. Despite an increased baseline cardiac output, cirrhotic patients have a suboptimal ventricular response to stress. This phenomenon is called cirrhotic cardiomyopathy. The pathogenesis of this syndrome is multifactorial and includes diminished β-adrenergic receptor signal transduction, cardiomyocyte cellular plasma membrane dysfunction, and increased activity or levels of cardiodepressant substances such as cytokines, endogenous cannabinoids, and nitric oxide. Although cirrhotic cardiomyopathy is usually clinically mild or silent, overt heart failure can be precipitated by stresses such as liver transplantation or transjugular intrahepatic portosystemic shunt insertion. Moreover, cirrhotic cardiomyopathy may play a role in the pathogenesis of hepatorenal syndrome. Treatment of this condition is mainly supportive. Orthotopic liver transplantation appears to improve or normalize the condition, generally after a period of several months.


Samuel S Lee, M.D. 

Liver Unit, University of Calgary

3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1