Cardiohepatic Interactions in Heart Failure an Overview
The impact of HF on hepatic function has been studied for many decades, but there is limited contemporary knowledge on the exact mechanisms underlying liver injury in the setting of HF, response to therapy, and the prognostic impact of LFT abnormalities across the spectrum of clinical HF. Although there is a growing body of literature regarding the prognostic impact of cardiohepatic interactions in the most advanced stages of the disease, there is potential for important avenues of investigation in acute decompensated HF and in the early stages of HF (American Heart Association stages A to C). Finally, the impact of the cardiohepatic axis on drug metabolism and drug effects (particularly for anticoagulant agents) will become increasingly important as more patients have HF and as additional novel therapeutics are introduced.
Heart failure constitutes as a significant source of morbidity and mortality for an aging population. Medical care is becoming more complex as patients live longer with multiple chronic disease processes. Because there are known therapies that have proven mortality benefits, it is imperative that the signs and symptoms of HF are quickly recognized and addressed. Recognizing these signs and symptoms can be challenging, however, due to potential subtle presentations in patients with complex medical histories. In parallel with continued research, we must continue to educate primary care physicians and physician-extenders to recognize and address HF-related cardiohepatic interactions to further reduce unnecessary healthcare spending and to decrease HF-associated morbidity and mortality.
Conclusions
The impact of HF on hepatic function has been studied for many decades, but there is limited contemporary knowledge on the exact mechanisms underlying liver injury in the setting of HF, response to therapy, and the prognostic impact of LFT abnormalities across the spectrum of clinical HF. Although there is a growing body of literature regarding the prognostic impact of cardiohepatic interactions in the most advanced stages of the disease, there is potential for important avenues of investigation in acute decompensated HF and in the early stages of HF (American Heart Association stages A to C). Finally, the impact of the cardiohepatic axis on drug metabolism and drug effects (particularly for anticoagulant agents) will become increasingly important as more patients have HF and as additional novel therapeutics are introduced.
Heart failure constitutes as a significant source of morbidity and mortality for an aging population. Medical care is becoming more complex as patients live longer with multiple chronic disease processes. Because there are known therapies that have proven mortality benefits, it is imperative that the signs and symptoms of HF are quickly recognized and addressed. Recognizing these signs and symptoms can be challenging, however, due to potential subtle presentations in patients with complex medical histories. In parallel with continued research, we must continue to educate primary care physicians and physician-extenders to recognize and address HF-related cardiohepatic interactions to further reduce unnecessary healthcare spending and to decrease HF-associated morbidity and mortality.
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