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Sammanfattning

Experimental and clinical studies of cirrhosis indicate the presence of latent heart failure. The new clinical entity cirrhotic cardiomyopathy is different from alcoholic heart muscle disease. Cirrhotic cardiomyopathy includes changes in myocardial contractility, preload and afterload, reduced beta-adrenoreceptor function, postreceptor dysfunction, deficient excitation-contraction coupling and, in some patients, a prolonged QT interval and arrhythmias. Clinically significant cardiac dysfunction and latent heart failure are present in a substantial percentage of patients with advanced cirrhosis. At present no specific treatment can be recommended, and manifest heart failure in patients with cirrhotic cardiomyopathy should be treated like congestive heart failure. Special notice should be paid to procedures potentially causing strain on the heart, such as surgery, shunt implantation and liver transplantation.

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