Journal
INTERNATIONAL JOURNAL OF ANGIOLOGY
Volume 20, Issue 3, Pages 135-142Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0031-1284434
Keywords
Heart failure; liver dysfunction; cardiovascular disease; pulsatile liver; hepatic congestion; shock liver; cardiac output
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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.
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