Hepatorenal Syndrome with Cirrhotic Cardiomyopathy: Case Report and Literature Review

Overview

Journal Case Reports Hepatol

Publisher Wiley

Specialty Gastroenterology

Date 2015 Apr 16

PMID 25874140

Citations 4

Authors

Luis Mocarzel

Pedro Lanzieri

Juliana Nascimento

Clara Peixoto

Mario Ribeiro

Evandro Mesquita

Affiliations

Soon will be listed here.

Abstract

The hepatorenal syndrome (HRS) is defined as a potentially reversible kidney failure in patients with cirrhosis and ascites. An association of HRS and cirrhotic cardiomyopathy has been reported recently, but there are no result studies about the use of positive inotropes as part of the acute phase treatment. We report the case of a patient diagnosed with HRS, with high levels of NT pro-BNP, but with normal ejection fraction of the left ventricle, which showed abnormalities in systolic function through speckle tracking in echocardiography, reversible after the infusion of dobutamine. The patient showed clinical and laboratory improvement of his renal function after the infusion of dobutamine. Clinical studies are needed on HRS therapeutic approach taking into account the myocardial dysfunction as a major contributing factor to renal dysfunction.

Citing Articles

Hepatocardiorenal syndrome in liver cirrhosis: Recognition of a new entity?.

Wu H, Rakisheva A, Ponnusamy A, Chinnadurai R World J Gastroenterol. 2024; 30(2):128-136.

PMID: 38312119 PMC: 10835518. DOI: 10.3748/wjg.v30.i2.128.

Cirrhotic Cardiomyopathy: A New Clinical Phenotype.

Mocarzel L, Rossi M, Miliosse B, Lanzieri P, Gismondi R Arq Bras Cardiol. 2017; 108(6):564-568.

PMID: 28699978 PMC: 5489327. DOI: 10.5935/abc.20170066.

Cirrhotic Cardiomyopathy: Another Case of a Successful Approach to Treatment of Hepatorenal Syndrome.

Mocarzel L, Bicca J, Jarske L, Oliveira T, Lanzieri P, Gismondi R Case Rep Gastroenterol. 2016; 10(3):531-537.

PMID: 27843430 PMC: 5091268. DOI: 10.1159/000448885.

Hepatorenal syndrome: Update on diagnosis and treatment.

Baraldi O, Valentini C, Donati G, Comai G, Cuna V, Capelli I World J Nephrol. 2015; 4(5):511-20.

PMID: 26558188 PMC: 4635371. DOI: 10.5527/wjn.v4.i5.511.

References

Nodari S, Palazzuoli A . Current treatment in acute and chronic cardio-renal syndrome. Heart Fail Rev. 2010; 16(6):583-94. DOI: 10.1007/s10741-010-9202-6. View

Kazankov K, Holland-Fischer P, Andersen N, Torp P, Sloth E, Aagaard N . Resting myocardial dysfunction in cirrhosis quantified by tissue Doppler imaging. Liver Int. 2011; 31(4):534-40. DOI: 10.1111/j.1478-3231.2011.02468.x. View

Iwanaga Y, Nishi I, Furuichi S, Noguchi T, Sase K, Kihara Y . B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure: comparison between systolic and diastolic heart failure. J Am Coll Cardiol. 2006; 47(4):742-8. DOI: 10.1016/j.jacc.2005.11.030. View

Caramelo C, Santos J, Blanchart A, Rodriguez-Puyol D, Lopez-Novoa J, Hernando L . Effect of volume expansion on hemodynamics, capillary permeability and renal function in conscious, cirrhotic rats. Hepatology. 1986; 6(1):129-34. DOI: 10.1002/hep.1840060125. View

Pall A, Czifra A, Vitalis Z, Papp M, Paragh G, Szabo Z . Pathophysiological and clinical approach to cirrhotic cardiomyopathy. J Gastrointestin Liver Dis. 2014; 23(3):301-10. DOI: 10.15403/jgld.2014.1121.233.apac. View

Zardi E, Abbate A, Zardi D, Dobrina A, Margiotta D, Van Tassell B . Cirrhotic cardiomyopathy. J Am Coll Cardiol. 2010; 56(7):539-49. DOI: 10.1016/j.jacc.2009.12.075. View

Mikulic E, Munoz C, Puntoni L, Lebrec D . Hemodynamic effects of dobutamine in patients with alcoholic cirrhosis. Clin Pharmacol Ther. 1983; 34(1):56-9. DOI: 10.1038/clpt.1983.129. View

Kim M, Baik S, Won C, Park H, Jeon H, Hong H . Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis. Korean J Hepatol. 2011; 16(4):376-82. PMC: 3304603. DOI: 10.3350/kjhep.2010.16.4.376. View

Moller S, Hove J, Dixen U, Bendtsen F . New insights into cirrhotic cardiomyopathy. Int J Cardiol. 2012; 167(4):1101-8. DOI: 10.1016/j.ijcard.2012.09.089. View

10.

Arroyo V, Garcia-Martinez R, Salvatella X . Human serum albumin, systemic inflammation, and cirrhosis. J Hepatol. 2014; 61(2):396-407. DOI: 10.1016/j.jhep.2014.04.012. View

11.

Padillo J, Rioja P, Munoz-Villanueva M, Vallejo J, Ciria R, Muntane J . BNP as marker of heart dysfunction in patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2010; 22(11):1331-6. DOI: 10.1097/MEG.0b013e32833e6b2a. View

12.

Arroyo V, Gines P, Gerbes A, DUDLEY F, Gentilini P, Laffi G . Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996; 23(1):164-76. DOI: 10.1002/hep.510230122. View

13.

Moller S, Henriksen J . Cardiovascular complications of cirrhosis. Gut. 2008; 57(2):268-78. DOI: 10.1136/gut.2006.112177. View

14.

Yancy C, Jessup M, Bozkurt B, Butler J, Casey Jr D, Drazner M . 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128(16):e240-327. DOI: 10.1161/CIR.0b013e31829e8776. View

15.

Wiese S, Hove J, Bendtsen F, Moller S . Cirrhotic cardiomyopathy: pathogenesis and clinical relevance. Nat Rev Gastroenterol Hepatol. 2013; 11(3):177-86. DOI: 10.1038/nrgastro.2013.210. View

16.

Moller S, Henriksen J . Cirrhotic cardiomyopathy: a pathophysiological review of circulatory dysfunction in liver disease. Heart. 2001; 87(1):9-15. PMC: 1766971. DOI: 10.1136/heart.87.1.9. View

17.

KOWALSKI H, Abelmann W . The cardiac output at rest in Laennec's cirrhosis. J Clin Invest. 1953; 32(10):1025-33. PMC: 438436. DOI: 10.1172/JCI102813. View

18.

Chayanupatkul M, Liangpunsakul S . Cirrhotic cardiomyopathy: review of pathophysiology and treatment. Hepatol Int. 2014; 8(3):308-15. PMC: 4160726. DOI: 10.1007/s12072-014-9531-y. View

19.

Moller S, Bernardi M . Interactions of the heart and the liver. Eur Heart J. 2013; 34(36):2804-11. DOI: 10.1093/eurheartj/eht246. View