Hepatocardiorenal syndrome in liver cirrhosis: Recognition of a new entity?
Wu H.H.L. Rakisheva A. Ponnusamy A. Chinnadurai R.
2024Baishideng Publishing Group Inc
World Journal of Gastroenterology
2024#30Issue 2128 - 136 pp.
Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome (HRS), outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this context. In the absence of established heart disease, cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney disease. It is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological abnormalities. Despite the clinical description of these potential cardiac-related complications of the liver, the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in HRS. Yet from a physiological sense, temporality (prior onset) of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic patients. In this review, we discuss current concepts surrounding how the heart may influence the development and progression of HRS, and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this setting. The temporality of heart and kidney dysfunction in HRS will be discussed. For a subgroup of patients who receive portosystemic shunting, the dynamics of cardiorenal interactions following treatment is reviewed. Continued research to determine the unknowns in this topic is anticipated, hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.
Cardiac dysfunction , Cardiorenal syndrome , Circulatory dysfunction , Cirrhosis , Hepatorenal syndrome
Text of the article Перейти на текст статьи
Renal Research, Kolling Institute of Medical Research, Royal North Shore Hospital, The University of Sydney, St. Leonards, Sydney, 2065, NSW, Australia
Department of Cardiology, City Cardiological Center, Almaty, 050000, Kazakhstan
Department of Renal Medicine, Royal Preston Hospital, Preston, PR2 9HT, United Kingdom
Donal O’Donoghue Renal Research Centre, Department of Renal Medicine, Northern Care Alliance National Health Service Foundation Trust, Salford, M6 8HD, United Kingdom
Renal Research, Kolling Institute of Medical Research, Royal North Shore Hospital, The University of Sydney, Reserve Road, St. Leonards, Sydney, 2065, NSW, Australia
Renal Research
Department of Cardiology
Department of Renal Medicine
Donal O’Donoghue Renal Research Centre
Renal Research
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026