Cardiología Ecocardiografista, Hospital Regional ISSSTE Puebla. Puebla, México.
Gastroenterología, Hospital Regional ISSSTE Puebla. Puebla, México.
Arch Cardiol Mex. 2020;90(2):169-177. doi: 10.24875/ACM.19000166.
Cirrhotic cardiomyopathy is characterized by the presence of structural and functional cardiac alterations in patients suffering from hepatic cirrhosis, without previously known cardiac causes that may explain it. Clinically, it is characterized by the presence of variable grades of diastolic and systolic dysfunction, alterations in the electric conductance (elongation of corrected QT interval) and inadequate chronotropic response. This pathology has been related to substandard response in the management of patients with portal hypertension and poor outcome after transplant. Even when the first description of this pathology dates back from 1953, it remains a poorly studied and frequently underdiagnosed entity. Echocardiography prevails as a practical diagnostic tool for this pathology since simple measurements as the E/A index can show diastolic dysfunction. Systolic dysfunction discloses as a diminished ejection fraction of the left ventricle and the latent forms are detected by echocardiography studies with pharmacological stress. In recent years new techniques such as the longitudinal strain have been studied and they seem promising for the detection of early alterations.
肝硬化性心肌病的特征是患有肝硬化的患者存在结构性和功能性心脏改变，而没有先前已知的可能解释其原因的心脏疾病。临床上，其特征在于存在不同程度的舒张和收缩功能障碍、电导率改变（校正 QT 间期延长）和自主神经反应不足。这种病理学与门静脉高压患者管理中的标准反应不足以及移植后预后不良有关。即使这种病理学的首次描述可以追溯到 1953 年，但它仍然是一个研究不足且经常被漏诊的实体。超声心动图作为这种病理学的实用诊断工具占主导地位，因为简单的测量，如 E/A 指数，可以显示舒张功能障碍。收缩功能障碍表现为左心室射血分数降低，而潜伏形式则通过超声心动图药物应激研究检测到。近年来，已经研究了一些新技术，如纵向应变，它们似乎有望用于早期改变的检测。
