Right heart involvement in hepatic diseases

Abstract

It is well known there is a relationship between the heart and the liver. A significant proportion of patients with heart failure have suffered at some point from congestive hepatopathy or developed ischemic hepatitis in acute situations. The aim of this chapter is to raise awareness about another situation involving the liver and the heart: patients with primary liver disease that affects the heart. It is a very interesting field, with lots of unknowns, but which deserves our attention as liver disease is prevalent amongst patients worldwide. In the first part, we will briefly explain the pathophysiology of portal hypertension (PoH), and its systemic consequences that influence heart function. Then, we will focus on three relevant clinical pathologies: cirrhotic cardiomyopathy (CCM), portopulmonary hypertension (PoPH) and hepatopulmonary syndrome (HPS). In the end we will briefly mention other liver disease that may affect the right heart.