Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Heart Disease and the Liver: Interactions Between the Heart and the Liver

  • Chapter
  • First Online:
The Liver in Systemic Diseases

  • 1437 Accesses

Abstract

Interactive complications between the heart and kidney can result in cardiorenal syndrome. Similar to this, there is also an interaction between the function of the heart and liver as well as a broad spectrum of acute and chronic entities that affect both of these organs, recognized as cardiohepatic syndrome. This chapter seeks to highlight the role of heart failure as a cause of liver dysfunction, the role of liver cirrhosis and nonalcoholic fatty liver disease as a cause of cardiovascular disease and/or heart disease, and finally, chronic alcoholism and systemic disorders, such as hemochromatosis and amyloidosis, which may affect the function of both the heart and liver.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ronco C, McCullough P, Anker SD, Anand I, Aspromonte N, Bagshaw SM, et al. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J. 2010;31(6):703–11.

    Article  PubMed  Google Scholar 

  2. Moller S, Bernardi M. Interactions of the heart and the liver. Eur Heart J. 2013;34(36):2804–11.

    Article  PubMed  Google Scholar 

  3. Fouad YM, Yehia R. Hepato-cardiac disorders. World J Hepatol. 2014;6(1):41–54.

    PubMed  PubMed Central  Google Scholar 

  4. Seeto RK, Fenn B, Rockey DC. Ischemic hepatitis: clinical presentation and pathogenesis. Am J Med. 2000;109(2):109–13.

    Article  CAS  PubMed  Google Scholar 

  5. Henrion J, Schapira M, Luwaert R, Colin L, Delannoy A, Heller FR. Hypoxic hepatitis: clinical and hemodynamic study in 142 consecutive cases. Medicine. 2003;82(6):392–406.

    Article  PubMed  Google Scholar 

  6. Dunn GD, Hayes P, Breen KJ, Schenker S. The liver in congestive heart failure: a review. Am J Med Sci. 1973;265(3):174–89.

    Article  CAS  PubMed  Google Scholar 

  7. Kubo SH, Walter BA, John DH, Clark M, Cody RJ. Liver function abnormalities in chronic heart failure. Influence of systemic hemodynamics. Arch Intern Med. 1987;147(7):1227–30.

    Article  CAS  PubMed  Google Scholar 

  8. Batin P, Wickens M, McEntegart D, Fullwood L, Cowley AJ. The importance of abnormalities of liver function tests in predicting mortality in chronic heart failure. Eur Heart J. 1995;16(11):1613–18.

    CAS  PubMed  Google Scholar 

  9. Mohamed R, Forsey PR, Davies MK, Neuberger JM. Effect of liver transplantation on QT interval prolongation and autonomic dysfunction in end-stage liver disease. Hepatology. 1996;23(5):1128–34.

    Article  CAS  PubMed  Google Scholar 

  10. Cazzaniga M, Salerno F, Pagnozzi G, Dionigi E, Visentin S, Cirello I, et al. Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt. Gut. 2007;56(6):869–75.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sherlock S. The liver in heart failure; relation of anatomical, functional, and circulatory changes. Br Heart J. 1951;13(3):273–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Myers RP, Cerini R, Sayegh R, Moreau R, Degott C, Lebrec D, et al. Cardiac hepatopathy: clinical, hemodynamic, and histologic characteristics and correlations. Hepatology. 2003;37(2):393–400.

    Article  PubMed  Google Scholar 

  13. Fonarow GC, Albert NM, Curtis AB, Gheorghiade M, Liu Y, Mehra MR, et al. Incremental reduction in risk of death associated with use of guideline-recommended therapies in patients with heart failure: a nested case-control analysis of IMPROVE HF. J Am Heart Assoc. 2012;1(1):16–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. McAlister FA, Wiebe N, Ezekowitz JA, Leung AA, Armstrong PW. Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med. 2009;150(11):784–94.

    Article  PubMed  Google Scholar 

  15. Ware LB, Matthay MA. Clinical practice. Acute pulmonary edema. N Engl J Med. 2005;353(26):2788–96.

    Article  CAS  PubMed  Google Scholar 

  16. Kasai T, Floras JS, Bradley TD. Sleep apnea and cardiovascular disease: a bidirectional relationship. Circulation. 2012;126(12):1495–510.

    Article  PubMed  Google Scholar 

  17. Yoshihisa A, Suzuki S, Yamaki T, Sugimoto K, Kunii H, Nakazato K, et al. Impact of adaptive servo-ventilation on cardiovascular function and prognosis in heart failure patients with preserved left ventricular ejection fraction and sleep-disordered breathing. Eur J Heart Fail. 2013;15(5):543–50.

    Article  CAS  PubMed  Google Scholar 

  18. Suzuki S, Yoshihisa A, Yamaki T, Sugimoto K, Kunii H, Nakazato K, et al. Long-term effects and prognosis in acute heart failure treated with tolvaptan: the AVCMA trial. BioMed Res Int. 2014;2014:704289.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Akiyama S, Ikeda K, Sezaki H, Fukushima T, Sorin Y, Kawamura Y, et al. Therapeutic effects of short- and intermediate-term tolvaptan administration for refractory ascites in patients with advanced liver cirrhosis. Hepatol Res: Off J Jpn Soc Hepatol. 2014;45(11):1062–70.

    Article  CAS  Google Scholar 

  20. Kavoliuniene A, Vaitiekiene A, Cesnaite G. Congestive hepatopathy and hypoxic hepatitis in heart failure: a cardiologist’s point of view. Int J Cardiol. 2013;166(3):554–8.

    Article  PubMed  Google Scholar 

  21. Birrer R, Takuda Y, Takara T. Hypoxic hepatopathy: pathophysiology and prognosis. Intern Med. 2007;46(14):1063–70.

    Article  PubMed  Google Scholar 

  22. Abe S, Yoshihisa A, Takiguchi M, Shimizu T, Nakamura Y, Yamauchi H, et al. Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure. PLoS One. 2014;9(6):e100618.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Taylor RM, Tujios S, Jinjuvadia K, Davern T, Shaikh OS, Han S, et al. Short and long-term outcomes in patients with acute liver failure due to ischemic hepatitis. Dig Dis Sci. 2012;57(3):777–85.

    Article  PubMed  Google Scholar 

  24. Henrion J, Minette P, Colin L, Schapira M, Delannoy A, Heller FR. Hypoxic hepatitis caused by acute exacerbation of chronic respiratory failure: a case-controlled, hemodynamic study of 17 consecutive cases. Hepatology. 1999;29(2):427–33.

    Article  CAS  PubMed  Google Scholar 

  25. Mathurin P, Durand F, Ganne N, Mollo JL, Lebrec D, Degott C, et al. Ischemic hepatitis due to obstructive sleep apnea. Gastroenterology. 1995;109(5):1682–4.

    Article  CAS  PubMed  Google Scholar 

  26. Ellenberg M, Osserman KE. The role of shock in the production of central liver cell necrosis. Am J Med. 1951;11(2):170–8.

    Article  CAS  PubMed  Google Scholar 

  27. Killip 3rd T, Payne MA. High serum transaminase activity in heart disease. Circulatory failure and hepatic necrosis. Circulation. 1960;21:646–60.

    Article  CAS  PubMed  Google Scholar 

  28. Clarke WT. Centrilobular hepatic necrosis following cardiac infarction. Am J Pathol. 1950;26(2):249–55.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Myers RP, Lee SS. Cirrhotic cardiomyopathy and liver transplantation. Liver Transplant. 2000;6(4 Suppl 1):S44–52.

    Article  CAS  Google Scholar 

  30. Fuhrmann V, Kneidinger N, Herkner H, Heinz G, Nikfardjam M, Bojic A, et al. Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients. Intensive Care Med. 2009;35(8):1397–405.

    Article  PubMed  Google Scholar 

  31. Weisberg IS, Jacobson IM. Cardiovascular diseases and the liver. Clin Liver Dis. 2011;15(1):1–20.

    Article  PubMed  Google Scholar 

  32. de Leeuw K, Meertens JH, van der Horst IC, van der Berg AP, Ligtenberg JJ, Tulleken JE, et al. “Acute liver failure”: the heart may be the matter. Acta Clin Belg. 2011;66(3):236–9.

    PubMed  Google Scholar 

  33. Cogger VC, Fraser R, Le Couteur DG. Liver dysfunction and heart failure. Am J Cardiol. 2003;91(11):1399.

    Article  PubMed  Google Scholar 

  34. Wanless IR, Liu JJ, Butany J. Role of thrombosis in the pathogenesis of congestive hepatic fibrosis (cardiac cirrhosis). Hepatology. 1995;21(5):1232–7.

    CAS  PubMed  Google Scholar 

  35. Lau GT, Tan HC, Kritharides L. Type of liver dysfunction in heart failure and its relation to the severity of tricuspid regurgitation. Am J Cardiol. 2002;90(12):1405–9.

    Article  PubMed  Google Scholar 

  36. Poelzl G, Ess M, Mussner-Seeber C, Pachinger O, Frick M, Ulmer H. Liver dysfunction in chronic heart failure: prevalence, characteristics and prognostic significance. Eur J Clin Invest. 2012;42(2):153–63.

    Article  CAS  PubMed  Google Scholar 

  37. Allen LA, Felker GM, Pocock S, McMurray JJ, Pfeffer MA, Swedberg K, et al. Liver function abnormalities and outcome in patients with chronic heart failure: data from the Candesartan in Heart Failure: assessment of Reduction in Mortality and Morbidity (CHARM) program. Eur J Heart Fail. 2009;11(2):170–7.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ambrosy AP, Vaduganathan M, Huffman MD, Khan S, Kwasny MJ, Fought AJ, et al. Clinical course and predictive value of liver function tests in patients hospitalized for worsening heart failure with reduced ejection fraction: an analysis of the EVEREST trial. Eur J Heart Fail. 2012;14(3):302–11.

    Article  CAS  PubMed  Google Scholar 

  39. Asrani SK, Asrani NS, Freese DK, Phillips SD, Warnes CA, Heimbach J, et al. Congenital heart disease and the liver. Hepatology. 2012;56(3):1160–9.

    Article  PubMed  Google Scholar 

  40. Wu FM, Ukomadu C, Odze RD, Valente AM, Mayer Jr JE, Earing MG. Liver disease in the patient with Fontan circulation. Congenit Heart Dis. 2011;6(3):190–201.

    Article  PubMed  Google Scholar 

  41. Bergman M, Vitrai J, Salman H. Constrictive pericarditis: a reminder of a not so rare disease. Eur J Intern Med. 2006;17(7):457–64.

    Article  PubMed  Google Scholar 

  42. Kim MS, Kato TS, Farr M, Wu C, Givens RC, Collado E, et al. Hepatic dysfunction in ambulatory patients with heart failure: application of the MELD scoring system for outcome prediction. J Am Coll Cardiol. 2013;61(22):2253–61.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Shinagawa H, Inomata T, Koitabashi T, Nakano H, Takeuchi I, Naruke T, et al. Prognostic significance of increased serum bilirubin levels coincident with cardiac decompensation in chronic heart failure. Circ J. 2008;72(3):364–9.

    Article  CAS  PubMed  Google Scholar 

  44. van Deursen VM, Damman K, Hillege HL, van Beek AP, van Veldhuisen DJ, Voors AA. Abnormal liver function in relation to hemodynamic profile in heart failure patients. J Card Fail. 2010;16(1):84–90.

    Article  PubMed  Google Scholar 

  45. Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124(1):91–6.

    Article  PubMed  Google Scholar 

  46. Matthews JC, Pagani FD, Haft JW, Koelling TM, Naftel DC, Aaronson KD. Model for end-stage liver disease score predicts left ventricular assist device operative transfusion requirements, morbidity, and mortality. Circulation. 2010;121(2):214–20.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Chokshi A, Cheema FH, Schaefle KJ, Jiang J, Collado E, Shahzad K, et al. Hepatic dysfunction and survival after orthotopic heart transplantation: application of the MELD scoring system for outcome prediction. J Heart Lung Transplant. 2012;31(6):591–600.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Yang JA, Kato TS, Shulman BP, Takayama H, Farr M, Jorde UP, et al. Liver dysfunction as a predictor of outcomes in patients with advanced heart failure requiring ventricular assist device support: use of the Model of End-stage Liver Disease (MELD) and MELD eXcluding INR (MELD-XI) scoring system. J Heart Lung Transplant. 2012;31(6):601–10.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Giallourakis CC, Rosenberg PM, Friedman LS. The liver in heart failure. Clin Liver Dis. 2002;6(4):947–67, viii-ix.

    Article  PubMed  Google Scholar 

  50. Shorey J, Schenker S, Combes B. Effect of acute hypoxia on hepatic excretory function. Am J Physiol. 1969;216(6):1441–52.

    CAS  PubMed  Google Scholar 

  51. Szwejkowski BR, Elder DH, Shearer F, Jack D, Choy AM, Pringle SD, et al. Pulmonary hypertension predicts all-cause mortality in patients with heart failure: a retrospective cohort study. Eur J Heart Fail. 2012;14(2):162–7.

    Article  PubMed  Google Scholar 

  52. Ghio S, Temporelli PL, Klersy C, Simioniuc A, Girardi B, Scelsi L, et al. Prognostic relevance of a non-invasive evaluation of right ventricular function and pulmonary artery pressure in patients with chronic heart failure. Eur J Heart Fail. 2013;15(4):408–14.

    Article  PubMed  Google Scholar 

  53. Valeriano V, Funaro S, Lionetti R, Riggio O, Pulcinelli G, Fiore P, et al. Modification of cardiac function in cirrhotic patients with and without ascites. Am J Gastroenterol. 2000;95(11):3200–5.

    Article  CAS  PubMed  Google Scholar 

  54. Ates F, Topal E, Kosar F, Karincaoglu M, Yildirim B, Aksoy Y, et al. The relationship of heart rate variability with severity and prognosis of cirrhosis. Dig Dis Sci. 2006;51(9):1614–18.

    Article  PubMed  Google Scholar 

  55. Kowalski HJ, Abelmann WH. The cardiac output at rest in Laennec’s cirrhosis. J Clin Invest. 1953;32(10):1025–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Lee RF, Glenn TK, Lee SS. Cardiac dysfunction in cirrhosis. Best Pract Res Clin Gastroenterol. 2007;21(1):125–40.

    Article  CAS  PubMed  Google Scholar 

  57. Liu H, Lee SS. Nuclear factor-kappaB inhibition improves myocardial contractility in rats with cirrhotic cardiomyopathy. Liver Int. 2008;28(5):640–8.

    Article  CAS  PubMed  Google Scholar 

  58. Moller S, Henriksen JH. Cardiovascular complications of cirrhosis. Gut. 2008;57(2):268–78.

    Article  CAS  PubMed  Google Scholar 

  59. Krag A, Bendtsen F, Mortensen C, Henriksen JH, Moller S. Effects of a single terlipressin administration on cardiac function and perfusion in cirrhosis. Eur J Gastroenterol Hepatol. 2010;22(9):1085–92.

    Article  CAS  PubMed  Google Scholar 

  60. Glenn TK, Honar H, Liu H, ter Keurs HE, Lee SS. Role of cardiac myofilament proteins titin and collagen in the pathogenesis of diastolic dysfunction in cirrhotic rats. J Hepatol. 2011;55(6):1249–55.

    Article  CAS  PubMed  Google Scholar 

  61. Bernardi M, Maggioli C, Dibra V, Zaccherini G. QT interval prolongation in liver cirrhosis: innocent bystander or serious threat? Expert Rev Gastroenterol Hepatol. 2012;6(1):57–66.

    Article  PubMed  Google Scholar 

  62. Krag A, Bendtsen F, Burroughs AK, Moller S. The cardiorenal link in advanced cirrhosis. Med Hypotheses. 2012;79(1):53–5.

    Article  PubMed  Google Scholar 

  63. Schrier RW. Decreased effective blood volume in edematous disorders: what does this mean? J Am Soc Nephrol. 2007;18(7):2028–31.

    Article  PubMed  Google Scholar 

  64. Moller S, Henriksen JH. Cirrhotic cardiomyopathy. J Hepatol. 2010;53(1):179–90.

    Article  PubMed  Google Scholar 

  65. Wong F, Girgrah N, Graba J, Allidina Y, Liu P, Blendis L. The cardiac response to exercise in cirrhosis. Gut. 2001;49(2):268–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Wong F. Cirrhotic cardiomyopathy. Hepatol Int. 2009;3(1):294–304.

    Article  PubMed  Google Scholar 

  67. Gaskari SA, Honar H, Lee SS. Therapy insight: cirrhotic cardiomyopathy. Nat Clin Pract Gastroenterol Hepatol. 2006;3(6):329–37.

    Article  CAS  PubMed  Google Scholar 

  68. Sola E, Gines P. Renal and circulatory dysfunction in cirrhosis: current management and future perspectives. J Hepatol. 2010;53(6):1135–45.

    Article  PubMed  Google Scholar 

  69. Saner FH, Neumann T, Canbay A, Treckmann JW, Hartmann M, Goerlinger K, et al. High brain-natriuretic peptide level predicts cirrhotic cardiomyopathy in liver transplant patients. Transplant Int. 2011;24(5):425–32.

    Article  CAS  Google Scholar 

  70. Kazankov K, Holland-Fischer P, Andersen NH, Torp P, Sloth E, Aagaard NK, et al. Resting myocardial dysfunction in cirrhosis quantified by tissue Doppler imaging. Liver Int. 2011;31(4):534–40.

    Article  PubMed  Google Scholar 

  71. Rabie RN, Cazzaniga M, Salerno F, Wong F. The use of E/A ratio as a predictor of outcome in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt. Am J Gastroenterol. 2009;104(10):2458–66.

    Article  PubMed  Google Scholar 

  72. Bernardi M, Calandra S, Colantoni A, Trevisani F, Raimondo ML, Sica G, et al. Q-T interval prolongation in cirrhosis: prevalence, relationship with severity, and etiology of the disease and possible pathogenetic factors. Hepatology. 1998;27(1):28–34.

    Article  CAS  PubMed  Google Scholar 

  73. Day CP, James OF, Butler TJ, Campbell RW. QT prolongation and sudden cardiac death in patients with alcoholic liver disease. Lancet. 1993;341(8858):1423–8.

    Article  CAS  PubMed  Google Scholar 

  74. Ytting H, Henriksen JH, Fuglsang S, Bendtsen F, Moller S. Prolonged Q-T(c) interval in mild portal hypertensive cirrhosis. J Hepatol. 2005;43(4):637–44.

    Article  PubMed  Google Scholar 

  75. Trevisani F, Merli M, Savelli F, Valeriano V, Zambruni A, Riggio O, et al. QT interval in patients with non-cirrhotic portal hypertension and in cirrhotic patients treated with transjugular intrahepatic porto-systemic shunt. J Hepatol. 2003;38(4):461–7.

    Article  PubMed  Google Scholar 

  76. Zambruni A, Trevisani F, Caraceni P, Bernardi M. Cardiac electrophysiological abnormalities in patients with cirrhosis. J Hepatol. 2006;44(5):994–1002.

    Article  CAS  PubMed  Google Scholar 

  77. Ward CA, Ma Z, Lee SS, Giles WR. Potassium currents in atrial and ventricular myocytes from a rat model of cirrhosis. Am J Physiol. 1997;273(2 Pt 1):G537–44.

    CAS  PubMed  Google Scholar 

  78. Henriksen JH, Bendtsen F, Hansen EF, Moller S. Acute non-selective beta-adrenergic blockade reduces prolonged frequency-adjusted Q-T interval (QTc) in patients with cirrhosis. J Hepatol. 2004;40(2):239–46.

    Article  CAS  PubMed  Google Scholar 

  79. Zambruni A, Trevisani F, Di Micoli A, Savelli F, Berzigotti A, Bracci E, et al. Effect of chronic beta-blockade on QT interval in patients with liver cirrhosis. J Hepatol. 2008;48(3):415–21.

    Article  PubMed  Google Scholar 

  80. Trevisani F, Di Micoli A, Zambruni A, Biselli M, Santi V, Erroi V, et al. QT interval prolongation by acute gastrointestinal bleeding in patients with cirrhosis. Liver Int. 2012;32(10):1510–15.

    Article  CAS  PubMed  Google Scholar 

  81. Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD single topic conference. Hepatology. 2003;37(5):1202–19.

    Article  PubMed  Google Scholar 

  82. Tiniakos DG, Vos MB, Brunt EM. Nonalcoholic fatty liver disease: pathology and pathogenesis. Annu Rev Pathol. 2010;5:145–71.

    Article  CAS  PubMed  Google Scholar 

  83. Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclerosis. 2007;191(2):235–40.

    Article  CAS  PubMed  Google Scholar 

  84. Targher G, Marra F, Marchesini G. Increased risk of cardiovascular disease in non-alcoholic fatty liver disease: causal effect or epiphenomenon? Diabetologia. 2008;51(11):1947–53.

    Article  CAS  PubMed  Google Scholar 

  85. Bhatia LS, Curzen NP, Calder PC, Byrne CD. Non-alcoholic fatty liver disease: a new and important cardiovascular risk factor? Eur Heart J. 2012;33(10):1190–200.

    Article  CAS  PubMed  Google Scholar 

  86. Brea A, Puzo J. Non-alcoholic fatty liver disease and cardiovascular risk. Int J Cardiol. 2013;167(4):1109–17.

    Article  PubMed  Google Scholar 

  87. Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363(14):1341–50.

    Article  CAS  PubMed  Google Scholar 

  88. Ekstedt M, Franzen LE, Mathiesen UL, Thorelius L, Holmqvist M, Bodemar G, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006;44(4):865–73.

    Article  CAS  PubMed  Google Scholar 

  89. Adams LA, Lymp JF, St Sauver J, Sanderson SO, Lindor KD, Feldstein A, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129(1):113–21.

    Article  PubMed  Google Scholar 

  90. Rafiq N, Bai C, Fang Y, Srishord M, McCullough A, Gramlich T, et al. Long-term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol. 2009;7(2):234–8.

    Article  PubMed  Google Scholar 

  91. Soderberg C, Stal P, Askling J, Glaumann H, Lindberg G, Marmur J, et al. Decreased survival of subjects with elevated liver function tests during a 28-year follow-up. Hepatology. 2010;51(2):595–602.

    Article  PubMed  Google Scholar 

  92. Musso G, Gambino R, Cassader M, Pagano G. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med. 2011;43(8):617–49.

    Article  PubMed  Google Scholar 

  93. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116(6):1413–19.

    Article  CAS  PubMed  Google Scholar 

  94. Dam-Larsen S, Franzmann M, Andersen IB, Christoffersen P, Jensen LB, Sorensen TI, et al. Long term prognosis of fatty liver: risk of chronic liver disease and death. Gut. 2004;53(5):750–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Targher G, Bertolini L, Rodella S, Tessari R, Zenari L, Lippi G, et al. Nonalcoholic fatty liver disease is independently associated with an increased incidence of cardiovascular events in type 2 diabetic patients. Diabetes Care. 2007;30(8):2119–21.

    Article  CAS  PubMed  Google Scholar 

  96. Jepsen P, Vilstrup H, Moller JK, Sorensen HT. Prognosis of patients with liver cirrhosis and spontaneous bacterial peritonitis. Hepatogastroenterology. 2003;50(54):2133–6.

    PubMed  Google Scholar 

  97. Hamaguchi M, Kojima T, Takeda N, Nagata C, Takeda J, Sarui H, et al. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease. World J Gastroenterol. 2007;13(10):1579–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Haring R, Wallaschofski H, Nauck M, Dorr M, Baumeister SE, Volzke H. Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels. Hepatology. 2009;50(5):1403–11.

    Article  PubMed  Google Scholar 

  99. Zhou YJ, Li YY, Nie YQ, Huang CM, Cao CY. Natural course of nonalcoholic fatty liver disease in southern China: a prospective cohort study. J Dig Dis. 2012;13(3):153–60.

    Article  PubMed  Google Scholar 

  100. Treeprasertsuk S, Leverage S, Adams LA, Lindor KD, St Sauver J, Angulo P. The Framingham risk score and heart disease in nonalcoholic fatty liver disease. Liver Int. 2012;32(6):945–50.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Stepanova M, Younossi ZM. Independent association between nonalcoholic fatty liver disease and cardiovascular disease in the US population. Clin Gastroenterol Hepatol. 2012;10(6):646–50.

    Article  PubMed  Google Scholar 

  102. Lazo M, Hernaez R, Bonekamp S, Kamel IR, Brancati FL, Guallar E, et al. Non-alcoholic fatty liver disease and mortality among US adults: prospective cohort study. BMJ. 2011;343:d6891.

    Article  PubMed  PubMed Central  Google Scholar 

  103. Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H, et al. Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults. Circulation. 2005;112(14):2130–7.

    Article  CAS  PubMed  Google Scholar 

  104. Lee DH, Silventoinen K, Hu G, Jacobs Jr DR, Jousilahti P, Sundvall J, et al. Serum gamma-glutamyltransferase predicts non-fatal myocardial infarction and fatal coronary heart disease among 28,838 middle-aged men and women. Eur Heart J. 2006;27(18):2170–6.

    Article  CAS  PubMed  Google Scholar 

  105. Schindhelm RK, Dekker JM, Nijpels G, Bouter LM, Stehouwer CD, Heine RJ, et al. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study. Atherosclerosis. 2007;191(2):391–6.

    Article  CAS  PubMed  Google Scholar 

  106. Wannamethee SG, Lennon L, Shaper AG. The value of gamma-glutamyltransferase in cardiovascular risk prediction in men without diagnosed cardiovascular disease or diabetes. Atherosclerosis. 2008;201(1):168–75.

    Article  CAS  PubMed  Google Scholar 

  107. Fraser A, Harris R, Sattar N, Ebrahim S, Smith GD, Lawlor DA. Gamma-glutamyltransferase is associated with incident vascular events independently of alcohol intake: analysis of the British Women’s Heart and Health study and meta-analysis. Arterioscler Thromb Vasc Biol. 2007;27(12):2729–35.

    Article  CAS  PubMed  Google Scholar 

  108. Dunn W, Xu R, Wingard DL, Rogers C, Angulo P, Younossi ZM, et al. Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study. Am J Gastroenterol. 2008;103(9):2263–71.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Goessling W, Massaro JM, Vasan RS, D'Agostino Sr RB, Ellison RC, Fox CS. Aminotransferase levels and 20-year risk of metabolic syndrome, diabetes, and cardiovascular disease. Gastroenterology. 2008;135(6):1935–44, 44 e1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Ruhl CE, Everhart JE. Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. Gastroenterology. 2009;136(2):477–85 e11.

    Article  CAS  PubMed  Google Scholar 

  111. Yun KE, Shin CY, Yoon YS, Park HS. Elevated alanine aminotransferase levels predict mortality from cardiovascular disease and diabetes in Koreans. Atherosclerosis. 2009;205(2):533–7.

    Article  CAS  PubMed  Google Scholar 

  112. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346(16):1221–31.

    Article  CAS  PubMed  Google Scholar 

  113. Kotronen A, Yki-Jarvinen H. Fatty liver: a novel component of the metabolic syndrome. Arterioscler Thromb Vasc Biol. 2008;28(1):27–38.

    Article  CAS  PubMed  Google Scholar 

  114. de Alwis NM, Day CP. Non-alcoholic fatty liver disease: the mist gradually clears. J Hepatol. 2008;48 Suppl 1:S104–12.

    Article  PubMed  CAS  Google Scholar 

  115. Bae JC, Rhee EJ, Lee WY, Park SE, Park CY, Oh KW, et al. Combined effect of nonalcoholic fatty liver disease and impaired fasting glucose on the development of type 2 diabetes: a 4-year retrospective longitudinal study. Diabetes Care. 2011;34(3):727–9.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Lopez-Suarez A, Guerrero JM, Elvira-Gonzalez J, Beltran-Robles M, Canas-Hormigo F, Bascunana-Quirell A. Nonalcoholic fatty liver disease is associated with blood pressure in hypertensive and nonhypertensive individuals from the general population with normal levels of alanine aminotransferase. Eur J Gastroenterol Hepatol. 2011;23(11):1011–17.

    CAS  PubMed  Google Scholar 

  117. Yilmaz Y, Alahdab YO, Yonal O, Kurt R, Kedrah AE, Celikel CA, et al. Microalbuminuria in nondiabetic patients with nonalcoholic fatty liver disease: association with liver fibrosis. Metabolism. 2010;59(9):1327–30.

    Article  CAS  PubMed  Google Scholar 

  118. Targher G, Bertolini L, Rodella S, Lippi G, Zoppini G, Chonchol M. Relationship between kidney function and liver histology in subjects with nonalcoholic steatohepatitis. Clin J Am Soc Nephrol. 2010;5(12):2166–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Arase Y, Suzuki F, Kobayashi M, Suzuki Y, Kawamura Y, Matsumoto N, et al. The development of chronic kidney disease in Japanese patients with non-alcoholic fatty liver disease. Intern Med. 2011;50(10):1081–7.

    Article  CAS  PubMed  Google Scholar 

  120. Chin K, Nakamura T, Takahashi K, Sumi K, Ogawa Y, Masuzaki H, et al. Effects of obstructive sleep apnea syndrome on serum aminotransferase levels in obese patients. Am J Med. 2003;114(5):370–6.

    Article  CAS  PubMed  Google Scholar 

  121. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046–53.

    Article  PubMed  Google Scholar 

  122. Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation. 2010;122(4):352–60.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Kotronen A, Westerbacka J, Bergholm R, Pietilainen KH, Yki-Jarvinen H. Liver fat in the metabolic syndrome. J Clin Endocrinol Metab. 2007;92(9):3490–7.

    Article  CAS  PubMed  Google Scholar 

  124. Korenblat KM, Fabbrini E, Mohammed BS, Klein S. Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects. Gastroenterology. 2008;134(5):1369–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  125. Peterson LR. Obesity and insulin resistance: effects on cardiac structure, function, and substrate metabolism. Curr Hypertens Rep. 2006;8(6):451–6.

    Article  CAS  PubMed  Google Scholar 

  126. Fabbrini E, Magkos F, Mohammed BS, Pietka T, Abumrad NA, Patterson BW, et al. Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity. Proc Natl Acad Sci U S A. 2009;106(36):15430–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  127. Sung KC, Ryan MC, Kim BS, Cho YK, Kim BI, Reaven GM. Relationships between estimates of adiposity, insulin resistance, and nonalcoholic fatty liver disease in a large group of nondiabetic Korean adults. Diabetes Care. 2007;30(8):2113–18.

    Article  CAS  PubMed  Google Scholar 

  128. Petersen KF, Dufour S, Savage DB, Bilz S, Solomon G, Yonemitsu S, et al. The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome. Proc Natl Acad Sci U S A. 2007;104(31):12587–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  129. Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153(6):907–17.

    Article  CAS  PubMed  Google Scholar 

  130. Kankaanpaa M, Lehto HR, Parkka JP, Komu M, Viljanen A, Ferrannini E, et al. Myocardial triglyceride content and epicardial fat mass in human obesity: relationship to left ventricular function and serum free fatty acid levels. J Clin Endocrinol Metab. 2006;91(11):4689–95.

    Article  CAS  PubMed  Google Scholar 

  131. Iacobellis G, Pellicelli AM, Grisorio B, Barbarini G, Leonetti F, Sharma AM, et al. Relation of epicardial fat and alanine aminotransferase in subjects with increased visceral fat. Obesity. 2008;16(1):179–83.

    Article  CAS  PubMed  Google Scholar 

  132. Iacobellis G, Lonn E, Lamy A, Singh N, Sharma AM. Epicardial fat thickness and coronary artery disease correlate independently of obesity. Int J Cardiol. 2011;146(3):452–4.

    Article  PubMed  Google Scholar 

  133. Semenkovich CF. Insulin resistance and atherosclerosis. J Clin Invest. 2006;116(7):1813–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  134. Yilmaz Y, Kurt R, Yonal O, Polat N, Celikel CA, Gurdal A, et al. Coronary flow reserve is impaired in patients with nonalcoholic fatty liver disease: association with liver fibrosis. Atherosclerosis. 2010;211(1):182–6.

    Article  CAS  PubMed  Google Scholar 

  135. Villanova N, Moscatiello S, Ramilli S, Bugianesi E, Magalotti D, Vanni E, et al. Endothelial dysfunction and cardiovascular risk profile in nonalcoholic fatty liver disease. Hepatology. 2005;42(2):473–80.

    Article  PubMed  Google Scholar 

  136. Senturk O, Kocaman O, Hulagu S, Sahin T, Aygun C, Konduk T, et al. Endothelial dysfunction in Turkish patients with non-alcoholic fatty liver disease. Intern Med J. 2008;38(3):183–9.

    Article  CAS  PubMed  Google Scholar 

  137. Vlachopoulos C, Manesis E, Baou K, Papatheodoridis G, Koskinas J, Tiniakos D, et al. Increased arterial stiffness and impaired endothelial function in nonalcoholic fatty liver disease: a pilot study. Am J Hypertens. 2010;23(11):1183–9.

    Article  PubMed  Google Scholar 

  138. Salvi P, Ruffini R, Agnoletti D, Magnani E, Pagliarani G, Comandini G, et al. Increased arterial stiffness in nonalcoholic fatty liver disease: the Cardio-GOOSE study. J Hypertens. 2010;28(8):1699–707.

    Article  CAS  PubMed  Google Scholar 

  139. Targher G, Bertolini L, Padovani R, Rodella S, Zoppini G, Zenari L, et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease. Diabetes Care. 2006;29(6):1325–30.

    Article  PubMed  Google Scholar 

  140. Kim HC, Kim DJ, Huh KB. Association between nonalcoholic fatty liver disease and carotid intima-media thickness according to the presence of metabolic syndrome. Atherosclerosis. 2009;204(2):521–5.

    Article  CAS  PubMed  Google Scholar 

  141. Fracanzani AL, Burdick L, Raselli S, Pedotti P, Grigore L, Santorelli G, et al. Carotid artery intima-media thickness in nonalcoholic fatty liver disease. Am J Med. 2008;121(1):72–8.

    Article  PubMed  Google Scholar 

  142. Volzke H, Robinson DM, Kleine V, Deutscher R, Hoffmann W, Ludemann J, et al. Hepatic steatosis is associated with an increased risk of carotid atherosclerosis. World J Gastroenterol. 2005;11(12):1848–53.

    Article  PubMed  PubMed Central  Google Scholar 

  143. Targher G, Bertolini L, Padovani R, Zenari L, Zoppini G, Falezza G. Relation of nonalcoholic hepatic steatosis to early carotid atherosclerosis in healthy men: role of visceral fat accumulation. Diabetes Care. 2004;27(10):2498–500.

    Article  PubMed  Google Scholar 

  144. Chen CH, Nien CK, Yang CC, Yeh YH. Association between nonalcoholic fatty liver disease and coronary artery calcification. Dig Dis Sci. 2010;55(6):1752–60.

    Article  PubMed  Google Scholar 

  145. Akabame S, Hamaguchi M, Tomiyasu K, Tanaka M, Kobayashi-Takenaka Y, Nakano K, et al. Evaluation of vulnerable coronary plaques and non-alcoholic fatty liver disease (NAFLD) by 64-detector multislice computed tomography (MSCT). Circ J. 2008;72(4):618–25.

    Article  PubMed  Google Scholar 

  146. Assy N, Djibre A, Farah R, Grosovski M, Marmor A. Presence of coronary plaques in patients with nonalcoholic fatty liver disease. Radiology. 2010;254(2):393–400.

    Article  PubMed  Google Scholar 

  147. Arslan U, Turkoglu S, Balcioglu S, Tavil Y, Karakan T, Cengel A. Association between nonalcoholic fatty liver disease and coronary artery disease. Coron Artery Dis. 2007;18(6):433–6.

    Article  PubMed  Google Scholar 

  148. Acikel M, Sunay S, Koplay M, Gundogdu F, Karakelleoglu S. Evaluation of ultrasonographic fatty liver and severity of coronary atherosclerosis, and obesity in patients undergoing coronary angiography. Anadolu Kardiyoloji Dergisi: AKD Anatol J Cardiol. 2009;9(4):273–9.

    Google Scholar 

  149. Mirbagheri SA, Rashidi A, Abdi S, Saedi D, Abouzari M. Liver: an alarm for the heart? Liver Int. 2007;27(7):891–4.

    Article  PubMed  Google Scholar 

  150. Alper AT, Hasdemir H, Sahin S, Onturk E, Akyol A, Nurkalem Z, et al. The relationship between nonalcoholic fatty liver disease and the severity of coronary artery disease in patients with metabolic syndrome. Turk Kardiyoloji Dernegi Arsivi: Turk Kardiyoloji Derneginin Yayin Organidir. 2008;36(6):376–81.

    Google Scholar 

  151. Fallo F, Dalla Pozza A, Sonino N, Lupia M, Tona F, Federspil G, et al. Non-alcoholic fatty liver disease is associated with left ventricular diastolic dysfunction in essential hypertension. Nutr Metab Cardiovasc Dis: NMCD. 2009;19(9):646–53.

    Article  CAS  PubMed  Google Scholar 

  152. Goland S, Shimoni S, Zornitzki T, Knobler H, Azoulai O, Lutaty G, et al. Cardiac abnormalities as a new manifestation of nonalcoholic fatty liver disease: echocardiographic and tissue Doppler imaging assessment. J Clin Gastroenterol. 2006;40(10):949–55.

    Article  PubMed  Google Scholar 

  153. Fotbolcu H, Yakar T, Duman D, Karaahmet T, Tigen K, Cevik C, et al. Impairment of the left ventricular systolic and diastolic function in patients with non-alcoholic fatty liver disease. Cardiol J. 2010;17(5):457–63.

    PubMed  Google Scholar 

  154. Witteles RM, Fowler MB. Insulin-resistant cardiomyopathy clinical evidence, mechanisms, and treatment options. J Am Coll Cardiol. 2008;51(2):93–102.

    Article  CAS  PubMed  Google Scholar 

  155. Lautamaki R, Borra R, Iozzo P, Komu M, Lehtimaki T, Salmi M, et al. Liver steatosis coexists with myocardial insulin resistance and coronary dysfunction in patients with type 2 diabetes. Am J Physiol Endocrinol Metab. 2006;291(2):E282–90.

    Article  CAS  PubMed  Google Scholar 

  156. Perseghin G, Lattuada G, De Cobelli F, Esposito A, Belloni E, Ntali G, et al. Increased mediastinal fat and impaired left ventricular energy metabolism in young men with newly found fatty liver. Hepatology. 2008;47(1):51–8.

    Article  CAS  PubMed  Google Scholar 

  157. Fraser A, Harris R, Sattar N, Ebrahim S, Davey Smith G, Lawlor DA. Alanine aminotransferase, gamma-glutamyltransferase, and incident diabetes: the British Women’s Heart and Health Study and meta-analysis. Diabetes Care. 2009;32(4):741–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  158. George A, Figueredo VM. Alcoholic cardiomyopathy: a review. J Card Fail. 2011;17(10):844–9.

    Article  PubMed  Google Scholar 

  159. Gramenzi A, Caputo F, Biselli M, Kuria F, Loggi E, Andreone P, et al. Review article: alcoholic liver disease--pathophysiological aspects and risk factors. Aliment Pharmacol Ther. 2006;24(8):1151–61.

    Article  CAS  PubMed  Google Scholar 

  160. Corrao G, Bagnardi V, Zambon A, Torchio P. Meta-analysis of alcohol intake in relation to risk of liver cirrhosis. Alcohol Alcohol. 1998;33(4):381–92.

    Article  CAS  PubMed  Google Scholar 

  161. Rehm J, Taylor B, Mohapatra S, Irving H, Baliunas D, Patra J, et al. Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev. 2010;29(4):437–45.

    Article  PubMed  Google Scholar 

  162. European Association for the Study of L. EASL clinical practical guidelines: management of alcoholic liver disease. J Hepatol. 2012;57(2):399–420.

    Article  Google Scholar 

  163. Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: a meta-analysis. Eur J Epidemiol. 2011;26(11):833–50.

    Article  PubMed  Google Scholar 

  164. Matsumori A. Hepatitis C, virus infection and cardiomyopathies. Circ Res. 2005;96(2):144–7.

    Article  CAS  PubMed  Google Scholar 

  165. Omura T, Yoshiyama M, Hayashi T, Nishiguchi S, Kaito M, Horiike S, et al. Core protein of hepatitis C virus induces cardiomyopathy. Circ Res. 2005;96(2):148–50.

    Article  CAS  PubMed  Google Scholar 

  166. Adinolfi LE, Restivo L, Zampino R, Guerrera B, Lonardo A, Ruggiero L, et al. Chronic HCV infection is a risk of atherosclerosis. Role of HCV and HCV-related steatosis. Atherosclerosis. 2012;221(2):496–502.

    Article  CAS  PubMed  Google Scholar 

  167. Miyajima I, Kawaguchi T, Fukami A, Nagao Y, Adachi H, Sasaki S, et al. Chronic HCV infection was associated with severe insulin resistance and mild atherosclerosis: a population-based study in an HCV hyperendemic area. J Gastroenterol. 2013;48(1):93–100.

    Article  PubMed  Google Scholar 

  168. Patane S, Marte F, Sturiale M, Dattilo G, Albanese A. Myocarditis and cardiomyopathy HIV associated. Int J Cardiol. 2011;146(3):e56–7.

    Article  PubMed  Google Scholar 

  169. Zubiaurre L, Zapata E, Bujanda L, Castillo M, Oyarzabal I, Gutierrez-Stampa MA, et al. Cytomegalovirus hepatitis and myopericarditis. World J Gastroenterol. 2007;13(4):647–8.

    Article  PubMed  PubMed Central  Google Scholar 

  170. Malavige GN, Fernando S, Fernando DJ, Seneviratne SL. Dengue viral infections. Postgrad Med J. 2004;80(948):588–601.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  171. Herr J, Mehrfar P, Schmiedel S, Wichmann D, Brattig NW, Burchard GD, et al. Reduced cardiac output in imported Plasmodium falciparum malaria. Malar J. 2011;10:160.

    Article  PubMed  PubMed Central  Google Scholar 

  172. Kitamura Y, Motoi M, Terada T. An autopsy case of ancient sarcoidosis associated with severe fibrosis in the liver and heart. Pathol Int. 1998;48(7):536–41.

    Article  CAS  PubMed  Google Scholar 

  173. Hegazi MO, Ahmed S. Atypical clinical manifestations of graves’ disease: an analysis in depth. J Thyroid Res. 2012;2012:768019.

    Article  PubMed  Google Scholar 

  174. Ripoll C, Yotti R, Bermejo J, Banares R. The heart in liver transplantation. J Hepatol. 2011;54(4):810–22.

    Article  PubMed  Google Scholar 

  175. Hlubocka Z, Marecek Z, Linhart A, Kejkova E, Pospisilova L, Martasek P, et al. Cardiac involvement in Wilson disease. J Inherit Metab Dis. 2002;25(4):269–77.

    Article  CAS  PubMed  Google Scholar 

  176. Dungu JN, Anderson LJ, Whelan CJ, Hawkins PN. Cardiac transthyretin amyloidosis. Heart. 2012;98(21):1546–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Akiomi Yoshihisa & Yasuchika Takeishi

Authors
  1. Akiomi Yoshihisa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuchika Takeishi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akiomi Yoshihisa .

Editor information

Editors and Affiliations

  1. Dept. Gastroenterology & Rheumatogy, Fukushima Med. Univ. School of Med., Fukushima, Fukushima, Japan

    Hiromasa Ohira

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Japan

About this chapter

Cite this chapter

Yoshihisa, A., Takeishi, Y. (2016). Heart Disease and the Liver: Interactions Between the Heart and the Liver. In: Ohira, H. (eds) The Liver in Systemic Diseases. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55790-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-55790-6_9

  • Published:

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55789-0

  • Online ISBN: 978-4-431-55790-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation