Cardiac involvement in liver cirrhosis.

Since liver cirrhosis involves most organs and systems, it can be defined as a systemic disease. Involvement of the cardiocirculatory system is crucial during the course of cirrhosis due its pathophysiological, clinical and therapeutic relationships with the liver. Cardiovascular and circulatory alterations are frequently observed in the late stages of cirrhosis and involve subclinical latent cardiomyopathy with hyperdynamic circulation characterized by increased cardiac output and decreased peripheral resistance. The pathogenesis of these hemodynamic alterations is still uncertain. These alterations should be taken into serious consideration during programming of therapy for the complications of cirrhosis, in particular ascites (diuretic treatment; paracentesis, LeVeen peritoneal-venous shunt) and portal hypertension (drug treatment with beta-blockers and/or vasodilators for the prevention of variceal bleeding).