From the Department of Medicine, Section of Gastroenterology & Hepatobiliary Diseases, New York Medical College and Westchester Medical Center, Valhalla, NY.
Cardiol Rev. 2022;30(3):111-122. doi: 10.1097/CRD.0000000000000379.
The heart and the liver display multifaceted, complex interactions that can be divided into cardiac effects of liver disease, hepatic effects of heart disease, and disease processes affecting both organs. In part 1 of this 2 part series, we discuss how acute and chronic heart failure can have devastating effects on the liver, such as acute cardiogenic liver injury and congestive hepatopathy. On the other hand, primary liver disease, such as cirrhosis, can lead to a plethora of cardiac insults representative in cirrhotic cardiomyopathy as systolic dysfunction, diastolic dysfunction, and electrophysiological disturbances. Nonalcoholic fatty liver disease has long been associated with cardiovascular events that increase mortality. The management of both disease processes changes when the other organ system becomes involved. This consideration is important with regard to a variety of interventions, most notably transplantation of either organ, as risk of complications dramatically rises in the setting of both heart and liver disease (discussed in part 2). As our understanding of the intricate communication between the heart and liver continues to expand so does our management.
心脏和肝脏之间存在着多方面、复杂的相互作用，可以分为肝病对心脏的影响、心脏病对肝脏的影响以及影响两个器官的疾病过程。在这两部分系列的第 1 部分中，我们将讨论急性和慢性心力衰竭如何对肝脏造成严重影响，如急性心源性肝损伤和充血性肝病。另一方面，原发性肝病，如肝硬化，可导致多种心脏损伤，表现为肝硬化心肌病中的收缩功能障碍、舒张功能障碍和电生理紊乱。非酒精性脂肪性肝病长期以来与心血管事件相关，这些事件会增加死亡率。当另一个器官系统受到影响时，这两种疾病过程的管理都会发生变化。这在涉及到器官移植的各种干预措施中尤为重要，因为在心脏和肝脏疾病的情况下，并发症的风险会急剧上升（在第 2 部分中讨论）。随着我们对心脏和肝脏之间复杂通讯的理解不断深入，我们的管理也在不断发展。
