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首页> 外文期刊>Journal of cardiology >Cirrhotic cardiomyopathy in the pre- and post-liver transplantation phase
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Cirrhotic cardiomyopathy in the pre- and post-liver transplantation phase

机译：肝移植前后肝硬化性心肌病

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Patients with advanced liver cirrhosis may develop a clinical syndrome characterized by a blunted contractile responsiveness to stress and/or altered diastolic relaxation, called "cirrhotic cardiomyopathy." This syndrome, which is initially asymptomatic, is often misdiagnosed due to the presence of symptoms that characterize other disorders present in patients with advanced liver cirrhosis, such as exercise intolerance, fatigue, and dyspnea. Stress and other conditions such as liver transplantation and transjugular intrahepatic portosystemic shunt (TIPS) may unmask this syndrome. Liver transplantation in this group of patients results in a clinical improvement and can be a cure for the cardiomyopathy. However, post-transplant prognosis depends on the identification of cirrhotics with cardiomyopathy in the pre-transplant phase; an early diagnosis of cirrhotic cardiomyopathy in the pre-transplant phase may avoid an acute onset or worsening of cardiac failure after liver transplantation. Since a preserved left ventricular ejection fraction may mask the presence of cirrhotic cardiomyopathy, the use of newer noninvasive diagnostic techniques (i.e. tissue Doppler, myocardial strain) is necessary to identify cirrhotics with this syndrome, in the pre-transplant phase. A pre-transplant treatment of heart failure in cirrhotics with cardiomyopathy improves the quality of life in this phase and reduces the complications during and immediately after liver transplantation. Since specific therapies for cirrhotic cardiomyopathy are lacking, due to the absence of a clear understanding of the pathophysiology of the cardiomyopathy, further research in this field is required. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
机译：晚期肝硬化患者可能会出现临床综合征，其特征是对压力的收缩反应迟钝和/或舒张功能改变，称为“肝硬化性心肌病”。最初无症状的该综合征通常由于存在某些症状而被误诊，这些症状是晚期肝硬化患者中存在的其他疾病的特征，例如运动耐量，疲劳和呼吸困难。压力和其他状况，例如肝移植和经颈静脉肝内门体分流术（TIPS），可能会掩盖该综合征。在这组患者中进行肝移植可改善临床状况，并可治愈心肌病。然而，移植后的预后取决于在移植前阶段肝硬化合并心肌病的鉴别。在移植前阶段对肝硬化性心肌病进行早期诊断可避免肝移植后急性发作或心力衰竭恶化。由于保留的左心室射血分数可能掩盖了肝硬化性心肌病的存在，因此在移植前阶段必须使用更新的非侵入性诊断技术（即组织多普勒，心肌张力）来鉴定具有该综合征的肝硬化患者。肝病合并心肌病的心力衰竭的移植前治疗可改善此阶段的生活质量，并减少肝移植期间和移植后的并发症。由于缺乏对心肌病的病理生理的清楚了解，因此缺乏针对肝硬化性心肌病的具体疗法，因此需要在该领域进行进一步的研究。 （C）2015年日本心脏病学会。由Elsevier Ltd.出版。保留所有权利。

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