Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)38310.18786/2072-0505-2016-44-6-12-28REVIEW ARTICLEОБЗОРCirrhotic cardiomyopathy and liver transplantationЦирротическая кардиомиопатия и трансплантация печениMalinovskayaYu. O.МалиновскаяЮ. О.
Russian Federation

Malinovskaya Yuliya – Postgraduate Student, Chair of Internal Diseases, Faculty of Basic Medicine, Physician, Department of Hepatology.

61/2-8 Shchepkina ul., Moscow, 129110, Russian Federation. Tel.: +7 (916) 493 36 08. E-mail: yumalinovskaya@gmail.com

Малиновская Юлия Олеговна – аспирант кафедры внутренних болезней факультета фундаментальной медицины,  врач отделения гепатологии.

129110, г. Москва, ул. Щепкина, 61/2–8, Российская Федерация. Тел.: +7 (916) 493 36 08. E-mail: yumalinovskaya@gmail.com

yumalinovskaya@gmail.comMoiseevS. V.МоисеевС. В.
Russian Federation

Moiseev Sergey V. – MD, PhD, Professor, Chair of Internal Diseases, Faculty of Basic Medicine 

Моисеев Сергей Валентинович – доктор медицинских наук, профессор кафедры внутренних болезней факультета фундаментальной медицины

MoysyukYa. G.МойсюкЯ. Г.
Russian Federation

Moysyuk Yan G. – MD, PhD, Professor, Chief Research Fellow, Department of Abdominal Surgery

Мойсюк Ян Геннадиевич – доктор медицинских наук, профессор, гл. научный сотрудник отделения абдоминальной хирургии

Lomonosov Moscow State University, MoscowМосковский государственный университет имени М.В. Ломоносова, МоскваMoscow Regional Research and Clinical Institute, MoscowМосковский областной научно-исследовательский клинический институт имени М.Ф. Владимирского, Москва150920164467757842909201629092016Copyright ©; 2016, Malinovskaya Y.O., Moiseev S.V., Moysyuk Y.G.Copyright ©; 2016, Малиновская Ю.О., Моисеев С.В., Мойсюк Я.Г.2016Malinovskaya Y.O., Moiseev S.V., Moysyuk Y.G.Малиновская Ю.О., Моисеев С.В., Мойсюк Я.Г.https://creativecommons.org/licenses/by/4.0https://almclinmed.ru/jour/article/view/383

Cirrhotic cardiomyopathy is a syndrome, which includes systolic and diastolic dysfunction and electrophysiological abnormalities in patients with liver cirrhosis in the absence of any cardiac disease. Several mechanisms seem to be involved in the pathogenesis of cirrhotic cardiomyopathy, such as impaired signaling of beta-receptors, altered trans-membrane ion currents and excess production of vasodilators. Clinical manifestation of cirrhotic cardiomyopathy is non-specific and is usually masked by the symptoms of cirrhosis. Despite frequent regression of cirrhotic cardiomyopathy after liver transplantation, myocardial dysfunction may lead to cardiac complications during transplantation surgery and post-operatively. Severe myocardial dysfunction may affect liver transplantation outcomes with an increase in cardiovascular mortality. Therefore, timely identification of cirrhotic cardiomyopathy is crucial for assessment of candidate patients for liver transplantation. At present, there is no specific therapy for cirrhotic cardiomyopathy. Recommended treatment should be aimed at support of myocardial function and prevention of decompensation.

Цирротическая кардиомиопатия – синдром, характеризующийся наличием систолической дисфункции, диастолической дисфункции и электрофизиологических    нарушений   у  пациентов с циррозом  печени в отсутствие других сердечно-сосудистых заболеваний.  В  патогенезе  этого состояния  играют роль  нарушение  проведения сигнала β-адренорецепторов, трансмембранных ионных потоков, гиперпродукция вазодилататоров.   Клинические   проявления    цирротической кардиомиопатии неспецифичны  и скрыты симптомами, характерными для цирроза печени. Несмотря на то что цирротическая кардиомиопатия часто регрессирует после трансплантации печени,  дисфункция  миокарда  может привести к развитию кардиологических  осложнений во время  трансплантации  и в послеоперационном периоде.  Тяжелая дисфункция миокарда  влияет на исходы трансплантации  печени,  увеличивая летальность в результате сердечно-сосудистых осложнений, поэтому своевременная диагностика цирротической кардиомиопатии важна на этапе  обследования кандидата  на трансплантацию печени. Специфического лечения  цирротической  кардиомиопатии на  данный  момент  не существует. Рекомендуемое  лечение направлено на поддержание функции миокарда и профилактику декомпенсации.

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