Elleuch Nour, Mrabet Soumaya, Ben Slama Aida, Jaziri Hanen, Hammami Aya, Brahim Ahlem, Ajmi Salem, Ksiaa Mehdi, Jmaa Ali
Tunis Med. 2020 Mar;98(3):206-210.
The presence of cardiocirculatory dysfunction in liver cirrhosis has been described since 1960 and it was exclusively attributed to alcoholic cardiomyopathie. Only in the last two decades, the term of cirrhotic cardiomyopathy (CCM) was introduced to describe cardiac dysfunction in patients with cirrhosis. This entity is currently underdiagnosed because the disease is usually latent and manifests when the patient is under stress. However, overt cardiac failure has been described after transjugular intrahepatic portosystemic shun and liver transplantation. The diagnosis of CCM is still difficult to determine because of the lack of specific diagnosis tools. CCM is characterized by systolic dysfunction, diastolic dysfunction and electrophysiological abnormalities. At present, there is no specific treatment outside liver transplantation in the light of increased mortality and postoperative complications.Our review provides an overview of CCM, its definition, prevalence, pathogenic mechanisms, clinical presentation, various explorations and management in light of the most recent published literature.
自1960年以来,肝硬化患者中心脏循环功能障碍的存在就已被描述,并且当时完全归因于酒精性心肌病。直到最近二十年,才引入了“肝硬化心肌病(CCM)”这一术语来描述肝硬化患者的心脏功能障碍。该病症目前诊断不足,因为该疾病通常是潜伏性的,在患者处于应激状态时才会显现。然而,经颈静脉肝内门体分流术和肝移植术后曾有明显心力衰竭的报道。由于缺乏特异性诊断工具,CCM的诊断仍然难以确定。CCM的特征是收缩功能障碍、舒张功能障碍和电生理异常。鉴于死亡率和术后并发症增加,目前除肝移植外尚无特异性治疗方法。我们的综述根据最近发表的文献,对CCM及其定义、患病率、发病机制、临床表现、各种检查和管理进行了概述。