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- W1594203445 abstract "End-stage liver disease and in particular cirrhosis of the liver may have a deleterious effect on all major organ systems. A significant cause of this effect is endothelial cell dysfunction. This dysfunction may be the result of the excessive shear force on the blood vessel wall caused by the typical high flow circulation that is seen in many cirrhotic patients. Inflammatory and vasoactive molecules that are either not cleared by the liver or are released by the diseased liver may also play a significant role in causing this endothelial dysfunction. It is well known that cardiac failure may cause liver dysfunction and damage, also the reverse is true. Cirrhosis of the liver may cause cardiac dysfunction. In fact if closely examined beta-receptor down-regulation may be present in every cirrhotic patient. Because the splanchnic arteriolar vasodilatation and overall reduction in systemic vascular resistance results in an increased cardiac output in the typical cirrhotic patient, a false sense of dynamic cardiac function may be engendered. Clinically significant cirrhotic cardiomyopathy may be present and not recognized. The effect of liver cirrhosis on the pulmonary vascular endothelium may result in arteriolar vasodilatation and the creation of pulmonary vascular shunts causing hypoxia. This is termed hepatopulmonary syndrome (HPS). If vascular remodeling with proliferation of vascular smooth muscle cells and medial hyperplasia occurs resulting in an increased resistance to blood flow, this causes pulmonary hypertension and right ventricular dysfunction. If this is associated with portal hypertension it is termed portopulmonary hypertension (POPH). The patient with cirrhosis of the liver presenting for liver transplantation requires careful evaluation preoperatively and intense monitoring perioperatively. The role of the Doppler echocardiogram has now become an essential tool for the successful management of these patients." @default.
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- W1594203445 date "2011-07-13" @default.
- W1594203445 modified "2023-10-02" @default.
- W1594203445 title "Cardiopulmonary Disease in the Liver Transplant Patient: The Role of Doppler Echocardiography" @default.
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- W1594203445 doi "https://doi.org/10.5772/23180" @default.
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