The End-Organ Impairment in Liver Cirrhosis: Appointments for Critical Care

Table 1

The pathophysiology of cardiovascular abnormalities.

Attenuated systolic and diastolic response to stress stimuli
Structural and histological changes in cardiac chambers
Electrophysiological abnormalities
Increased serum markers of cardiac stress
Altered function of β-adrenergic and muscarinic receptors:
(i) Reduced receptor density in cirrhotic patients and animal model
(ii) Enhanced muscarinic: contributing to the negative inotropic effect on the myocardium
(iii) Altered membrane fluidity: these changes have a profound effect on the β- adrenoceptor function that includes impairing; the receptor-ligand interaction and affects the function of membrane-bound ion channels (Ca^++ and K^+)
NO, carbon monoxide, and endocannabinoids exerts a negative effect on cardiac contractility