Cirrhotic cardiomyopathy; Pathophysiology and clinical approach

Cardiac dysfunction is considerably discovered in patients with liver cirrhosis. Cirrhotic cardiomyopathy (CCM) has newly been assigned to as an entity separate of the cirrhosis etiology. Increased cardiac output due to hyperdynamic circulation, left ventricular dysfunction (systolic and diastolic) and certain electro-physiological abnormal findings are pathophysiological features of the disease. The main underlying mechanisms are complex, including the impaired β-receptor and calcium signaling, altered cardiomyocyte membrane physiology, elevated sympathetic nervous tone and increased activity of vasodilatory pathways. CCM character is impaired cardiac response to stress (physical, physiological and pharmacological). Currently, no specific therapy has proved effective yet. Echocardiography and electrocardiography are the corner stones for diagnosis. In this review, we discuss in brief the pathophysiological bachground and clinical features of cirrhotic cardiomyopathy, diagnosis and the currently available treatment options.