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非酒精性脂肪性肝病和肝硬化如何影响心脏。

How non-alcoholic fatty liver disease and cirrhosis affect the heart.

机构信息

Department Clinical Physiology and Nuclear Medicine 260, Center for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Copenhagen University Hospital, Kettegaards alle 30, 2650, Hvidovre, Denmark.

Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

Hepatol Int. 2023 Dec;17(6):1333-1349. doi: 10.1007/s12072-023-10590-1. Epub 2023 Sep 28.

Abstract

Liver diseases affect the heart and the vascular system. Cardiovascular complications appear to be a leading cause of death in patients with non-alcoholic fatty liver disease (NAFLD) and cirrhosis. The predominant histological changes in the liver range from steatosis to fibrosis to cirrhosis, which can each affect the cardiovascular system differently. Patients with cirrhotic cardiomyopathy (CCM) and NAFLD are at increased risk of impaired systolic and diastolic dysfunction and for suffering major cardiovascular events. However, the pathophysiological mechanisms behind these risks differ depending on the nature of the liver disease. Accurate assessment of symptoms by contemporary diagnostic modalities is essential for identifying patients at risk, for evaluating candidates for treatment, and prior to any invasive procedures. This review explores current perspectives within this field.

摘要

肝脏疾病会影响心脏和血管系统。心血管并发症似乎是非酒精性脂肪肝 (NAFLD) 和肝硬化患者死亡的主要原因。肝脏的主要组织学变化从脂肪变性到纤维化再到肝硬化,它们都会对心血管系统产生不同的影响。患有肝硬化性心肌病 (CCM) 和 NAFLD 的患者发生收缩和舒张功能障碍以及发生重大心血管事件的风险增加。然而,这些风险背后的病理生理机制因肝病的性质而异。通过现代诊断方法准确评估症状对于识别高危患者、评估治疗候选者以及在任何侵入性程序之前都是至关重要的。本综述探讨了该领域的当前观点。

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