Heart failure and liver disease: cardiohepatic interactions

Diana Sasu; Mihaela Stoica; Aiswarya Aiswarya; Valeriu Istrati

doi:10.52556/2587-3873.2025.2(104).27

Heart failure and liver disease: cardiohepatic interactions

Autori

Diana Sasu Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0009-0008-4501-0612
Mihaela Stoica Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0000-0002-2986-9039
Aiswarya Aiswarya Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“
Valeriu Istrati Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0000-0002-9507-367X

DOI:

https://doi.org/10.52556/2587-3873.2025.2(104).27

Cuvinte cheie:

heart failure, congestive hepatopathy, ischemichepatitis, cardiohepatic syndrom

Rezumat

Heart failure (HF) is a complex clinical syndrome that affects multiple organ systems, including the liver. The interplay between the heart and liver is bidirectional and often underrecognized, with hepatic congestion and hypoperfusion significantly contributing to patient morbidity and mortality. Understanding this interaction is critical to improving diagnostic accuracy and therapeutic strategies. The aim of the research was to investigate the underlying pathophysiological mechanisms, clinical significance, and diagnostic complexities associated with hepatic involvement in heart failure. A comprehensive literature review was conducted to explore the interrelationship between heart failure and liver disease, with a particular focus on congestive hepatopathy, ischemic hepatitis, and overall cardiohepatic interactions. Elevated central venous pressure in right-sided HF leads to hepatic congestion, sinusoidal dilatation, hepatocellular atrophy, and ultimately fibrosis—known as congestive hepatopathy. In severe cases, cardiac cirrhosis develops. Acute reductions in cardiac output, particularly in the setting of decompensated heart failure, can lead to ischemic hepatitis—also known as acute hypoxic hepatitis—characterized by significant elevations in liver enzymes and associated with adverse clinical outcomes. Neurohormonal imbalances, such as RAAS and SNS overactivation, further aggravate hepatic injury and promote systemic inflammation. Additionally, gut involvement through intestinal edema and dysbiosis forms a gut-liver-heart axis, exacerbating cachexia and disease progression. Cardiohepatic interactions significantly influence the clinical course of HF. Early recognition of liver dysfunction, including subclinical forms, is essential for comprehensive care. A multidisciplinary approach targeting hemodynamic stability, congestion relief, and gut-liver support holds promise in improving prognosis and reducing complications in HF patients.

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Descărcări

Publicat

01.12.2025

Număr

Nr. 2(104) (2025): Supliment. Al VI-lea Congres Național de Gastroenterologie și Hepatologie din Republica Moldova cu participare internațională

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Această lucrare este licențiată în temeiul Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Cum cităm

[1]

Sasu, D. et al. 2025. Heart failure and liver disease: cardiohepatic interactions. Public Health Economy and Management in Medicine. 2(104) (Dec. 2025), 147–154. DOI:https://doi.org/10.52556/2587-3873.2025.2(104).27.