Abstract
Liver cirrhosis is a chronic disease often characterized by pronounced hemodynamic alterations affecting both the systemic and the splanchnic circulation. These circulatory changes lead to the development of extrahepatic complications involving numerous organ systems as a multi-organ failure syndrome. In the heart, alterations of the cardiac function are frequently reported with a decrease in cardiac performance and the systolic and diastolic function, which may contribute to other complications such as renal failure. The circulatory changes activate potent counter-regulatory neurohumoral mechanisms including the renin-angiotensin-aldosterone, the sympatho-adrenergic, and the vasopressin systems. Additionally, several vasoactive substances are involved in the pathogenesis of the circulatory and cardiac dysfunction in cirrhosis, and within the recent years our knowledge on the role of natriuretic peptides, cardiac troponin, endothelins, calcitonin gene-related peptide, adrenomedullin, and nitric oxide has improved considerably. Furthermore, activated cytokines such as IL-6 and TNF-α seem to aggravate the circulatory dysfunction. Cardiovascular markers have been related to both morbidity and mortality in advanced cirrhosis and may therefore serve as important prognostic markers.
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Abbreviations
- ANP:
-
Atrial natriuretic peptide
- AVP:
-
Arginine vasopressin (also known as the antidiuretic hormone)
- BNP:
-
Brain natriuretic peptide
- CGRP:
-
Calcitonin gene-related peptide
- CNP:
-
C-type natriuretic peptide
- HPS:
-
Hepatopulmonary syndrome
- HRS:
-
Hepatorenal syndrome
- Hs-TnT:
-
High-sensitivity troponin T
- IL-6:
-
Interleukin 6
- LVEF:
-
Left ventricle ejection fraction
- NO:
-
Nitric oxide
- ProADM:
-
Adrenomedullin prohormone
- ProANP:
-
Atrial natriuretic peptide prohormone
- ProBNP:
-
Brain natriuretic peptide prohormone
- ProCNP:
-
C-type natriuretic peptide prohormone
- RAAS:
-
Renin-angiotensin-aldosterone system
- SBP:
-
Spontaneous bacterial peritonitis
- SNS:
-
Sympathetic nervous system
- TIPS:
-
Transjugular intrahepatic portosystemic shunt
- TNF-α:
-
Tumor necrosis factor alpha
- VEGF:
-
Vascular endothelial growth factor
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Wiese, S., Bendtsen, F., Møller, S. (2016). Cardiac Biomarkers in Cirrhosis and Portal Hypertension: Relation to Circulatory and Cardiac Dysfunction. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7678-4_19
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