Duke Clinical Research Institute and the Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Duke Clinical Research Institute and the Department of Medicine, Duke University Medical Center, Durham, North Carolina.
J Am Coll Cardiol. 2013 Jun 18;61(24):2397-2405. doi: 10.1016/j.jacc.2013.03.042. Epub 2013 Apr 17.
Heart failure (HF) is a major public health problem leading to frequent hospitalizations, impaired quality of life, and shortened life expectancy. Heart failure leads to a chronic inability to meet metabolic requirements of end organs or skeletal muscle. Current literature lacks comprehensive descriptions of HF effects on hepatic function. In this review paper, we summarize the literature that is available in hopes of highlighting the key differences in clinical presentation, histological findings, and biochemical profiles of patients who present with both acute and chronic liver injury secondary to HF. We further discuss the use of liver function tests as prognostic markers in patients with HF, as well as the implications of liver injury on drug metabolism in this patient population. Finally, we provide recommendations regarding the management of both types of liver injury in HF patients.
心力衰竭(HF)是一个主要的公共卫生问题,导致频繁住院、生活质量受损和预期寿命缩短。心力衰竭导致终末器官或骨骼肌的代谢需求长期无法得到满足。目前的文献缺乏对心力衰竭对肝功能影响的全面描述。在这篇综述论文中,我们总结了现有的文献,希望能突出因 HF 导致的急性和慢性肝损伤患者在临床表现、组织学发现和生化特征方面的关键差异。我们还进一步讨论了肝功能试验在 HF 患者中的预后标志物的应用,以及肝损伤对该患者人群药物代谢的影响。最后,我们就 HF 患者两种类型的肝损伤的治疗提出了建议。