Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment

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Hepatic transplantation (HT) is the standard of care of end-stage liver disease with Cirrhotic Cardiomyopathy (CCM), but medical treatment with combination of diuretics and non-selective beta blockers are important before and after that. Owing to its particular pathophysiology unlike another etiolog...

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Autores principales: Ramos, Hugo, Altieri, Mario
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2024
Materias:
liver cirrhosis
cardiomyopathy
treatment
liver transplantation
cirrosis hepática
cardiomiopatía
tratamiento
trasplante hepático
cirrose hepática
tratamento
transplante de fígado
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/44420
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-44420
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic liver cirrhosis
cardiomyopathy
treatment
liver transplantation
cirrosis hepática
cardiomiopatía
tratamiento
trasplante hepático
cirrose hepática
cardiomiopatía
tratamento
transplante de fígado
spellingShingle liver cirrhosis
cardiomyopathy
treatment
liver transplantation
cirrosis hepática
cardiomiopatía
tratamiento
trasplante hepático
cirrose hepática
cardiomiopatía
tratamento
transplante de fígado
Ramos, Hugo
Altieri, Mario
Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment
topic_facet liver cirrhosis
cardiomyopathy
treatment
liver transplantation
cirrosis hepática
cardiomiopatía
tratamiento
trasplante hepático
cirrose hepática
cardiomiopatía
tratamento
transplante de fígado
author Ramos, Hugo
Altieri, Mario
author_facet Ramos, Hugo
Altieri, Mario
author_sort Ramos, Hugo
title Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment
title_short Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment
title_full Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment
title_fullStr Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment
title_full_unstemmed Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment
title_sort cirrhotic cardiomyopathy – clinically fact or academic curiosity? review.: part 3: treatment
description Hepatic transplantation (HT) is the standard of care of end-stage liver disease with Cirrhotic Cardiomyopathy (CCM), but medical treatment with combination of diuretics and non-selective beta blockers are important before and after that. Owing to its particular pathophysiology unlike another etiologies of heart failure, in CCM angiotensin-converting enzyme inhibitors (ACEI), angiotensin II type I receptor blockers (ARB), and angiotensin receptor neprilysin inhibitor (ARNI) are not recommended. Transjugular intrahepatic porto-systemic shunt (TIPS) has indications in CMM but its potential benefits and risks must be considered and more researh is necessary. HT is a demanding therapy but the most effective one, and showed improvement in QTc, diastolic and systolic dysfunction; in recent decades, in spite of more severe ill patients (more severe MELD score), survival has improved significantly due to better surgical techniques, intensive care, immunosupresive drugs, and images.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2024
url https://revistas.unc.edu.ar/index.php/med/article/view/44420
work_keys_str_mv AT ramoshugo cirrhoticcardiomyopathyclinicallyfactoracademiccuriosityreviewpart3treatment
AT altierimario cirrhoticcardiomyopathyclinicallyfactoracademiccuriosityreviewpart3treatment
AT ramoshugo cardiomiopatiacirroticarealidadclinicaosimplecuriosidadacademicarevisionparte3tratamiento
AT altierimario cardiomiopatiacirroticarealidadclinicaosimplecuriosidadacademicarevisionparte3tratamiento
AT ramoshugo cardiomiopatiacirroticarealidadeclinicaousimplescuriosidadesacademicasrevisaoparte3tratamento
AT altierimario cardiomiopatiacirroticarealidadeclinicaousimplescuriosidadesacademicasrevisaoparte3tratamento
first_indexed 2025-02-05T22:05:33Z
last_indexed 2025-02-05T22:05:33Z
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spelling I10-R327-article-444202024-12-05T12:49:49Z Cirrhotic cardiomyopathy – Clinically fact or academic curiosity? Review.: Part 3: treatment Cardiomiopatía cirrótica – ¿Realidad clínica o simple curiosidad académica? Revisión. : Parte 3: tratamiento Cardiomiopatia cirrótica - ¿Realidade clínica ou simples curiosidades acadêmicas? Revisão. : Parte 3: tratamento Ramos, Hugo Altieri, Mario liver cirrhosis cardiomyopathy treatment liver transplantation cirrosis hepática cardiomiopatía tratamiento trasplante hepático cirrose hepática cardiomiopatía tratamento transplante de fígado Hepatic transplantation (HT) is the standard of care of end-stage liver disease with Cirrhotic Cardiomyopathy (CCM), but medical treatment with combination of diuretics and non-selective beta blockers are important before and after that. Owing to its particular pathophysiology unlike another etiologies of heart failure, in CCM angiotensin-converting enzyme inhibitors (ACEI), angiotensin II type I receptor blockers (ARB), and angiotensin receptor neprilysin inhibitor (ARNI) are not recommended. Transjugular intrahepatic porto-systemic shunt (TIPS) has indications in CMM but its potential benefits and risks must be considered and more researh is necessary. HT is a demanding therapy but the most effective one, and showed improvement in QTc, diastolic and systolic dysfunction; in recent decades, in spite of more severe ill patients (more severe MELD score), survival has improved significantly due to better surgical techniques, intensive care, immunosupresive drugs, and images. El tratamiento de la enfermedad hepática terminal con Cardiomiopatía Cirrótica (CMC) es el trasplante hepático (TH), sin embargo el tratamiento médico con la combinación de diuréticos y beta bloqueantes no selectivos antes y después tienen un rol importante. A diferencia de la insuficiencia cardíaca de otras etiologías, los inhibidores de la enzima convertidora (IECA), los bloqueadores del receptor de angiotensina 2 (ARA-2) o los inhibidores del receptor de angiotensina y de neprilisina (ARNI) no se recomiendan debido a la fisiopatología particular de la CMC. El shunt porto-sistémico intrahepático transyugular (Transjugular intrahepatic porto-systemic shunt: TIPS) tiene sus indicaciones con posibles beneficios y riesgos pero más estudios son necesarios en la CMC. El TH es la opción más eficaz y puede revertir el QTc del ECG y la disfunción diastólica y sistólica; en las últimas décadas, a pesar del aumento de la complejidad en los pacientes (mayor score MELD), con la mejoría de la técnica quirúrgica, cuidados intensivos, drogas inmunosupresoras y diagnóstico por imágenes la sobrevida ha mejorado significativamente. O tratamento da doença hepática terminal com Cardiomiopatia Cirrótica (CMC) e o transplante hepático (TH), no entanto o tratamento médico com a combinação de diuréticos e beta bloqueadores não seletivos antes e depois possuem um papel importante. A diferença da insuficiência cardíaca de outras etiologias, os inibidores da enzima convertidora (IECA), os bloqueadores do receptor de angiotensina 2 (ARA-2) ou os inibidores do receptor de angiotensina e de neprilisina (ARNI) não são recomendados devido a fisiopatologia particular da CMC. O shunt porto-sistémico intra-hepático transjugular (Transjugular intrahepatic porto-systemic shunt: TIPS) também pode ser indicado com possíveis benefícios e riscos, mas na CMC são necessários maiores exames. O TH e uma opção complexa, mas com maior eficácia e pode reverter o QTc do ECG e a disfunção diastólica e sistólica. Nas últimas décadas, apesar do aumento da complexidade nos pacientes (maior score MELD), com a melhoria das técnicas cirúrgicas, os cuidados intensivos, medicamentos imunossupressores e diagnostico por imagens há sobrevida há melhorado significativamente. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2024-09-27 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/44420 10.31053/1853.0605.v81.n3.44420 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 81 No. 3 (2024); 608-626 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 81 Núm. 3 (2024); 608-626 Revista da Faculdade de Ciências Médicas de Córdoba; v. 81 n. 3 (2024); 608-626 1853-0605 0014-6722 10.31053/1853.0605.v81.n3 spa https://revistas.unc.edu.ar/index.php/med/article/view/44420/46743 https://revistas.unc.edu.ar/index.php/med/article/view/44420/46577 Derechos de autor 2024 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0

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