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Liver and heart failure: an ultrasound relationship

  • Anna Lombardi ORCID logo EMAIL logo , Michele Gambardella , Stefano Palermi , Francesca Frecentese , Alessandro Serio , Simona Sperlongano , Rita Tavarozzi , Antonello D’andrea , Massimo De Luca and Cecilia Politi
Published/Copyright: September 19, 2022
Journal of Basic and Clinical Physiology and Pharmacology
From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 34 Issue 1

Abstract

Liver and heart are anatomically and patho-physiologically related. In heart failure (HF) the increased right atrial pressure and volume overload cause histological changes in hepatocytes, leading to a condition known as “congestive hepatopathy” (CH), with consequent variations in liver functioning and ultrasound (US) findings. CH has specifical US findings especially regarding venous vessels aspect, easily detecting by gray-scale study, but many others can be distinguished by Doppler analysis. Usually, hepatic veins look enlarged and hypocollassing, together with signs of portal hypertension (hepatomegaly, ascites, splenomegaly, porto-systemic collaterals). Typically, in CH Doppler findings regard alterations in venous vessel flow and arterial resistance (venous system hyperpulsatility, reduced velocity flow, high resistance index in hepatic arterial Doppler spectrum). Sometimes CH and other primary hepatopathy can coexist, and therefore some of the expected variations may not manifest: it allows suspecting an unknown underlying liver disease. At last, US technologies of more recent applications, even if not routinely used, allow investigating additional aspects such as elastography that detects changes in liver elasticity or contrastographic US, able to show differences in hepatic venous opacification. However, most of these US signs are not pathognomonic, and therefore a multidisciplinary clinical reasoning must not be lacking. The aim of the present review is to easily provide US signs of liver alterations in HF, in particular right heart failure with volume overload, suggesting including liver US in instrumental diagnosis and therapeutic monitoring of HF.

Keywords: congestive hepatopathy; heart failure; liver; ultrasound; volume overload
Corresponding author: Anna Lombardi, Department of Internal Medicine, Veneziale Hospital, ASREM, Isernia, Italy, phone: 0039-3276539201, E-mail:

Acknowledgments

The authors thank Dr. Corrado Caiazzo (Breast Service, Local Health Agency of Naples ASL NA1, Naples) for his availability and his teachings to young specialists who are passionate about ultrasound.

  1. Research funding: The authors report no involvement in the research by the sponsor that could have influenced the outcome of this work.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. Anna Lombardi, Michele Gambardella and Stefano Palermi have given substantial contributions to the conception or the design of the manuscript, all other authors to acquisition, analysis and interpretation of the data. All authors have participated to drafting the manuscript, Anna Lombardi revised it critically. All authors read and approved the final version of the manuscript.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2022-08-06
Accepted: 2022-08-22
Published Online: 2022-09-19

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jbcpp-2022-0211
Keywords for this article
congestive hepatopathy; heart failure; liver; ultrasound; volume overload

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Peyronie’s disease: where are we at?
  4. Reviews
  5. Catheter-associated urinary tract infection: an overview
  6. Liver and heart failure: an ultrasound relationship
  7. Original Articles
  8. The intracellular fluid compartment is smaller than commonly believed when measured by whole-body bioimpedance
  9. Prevalence and distribution of causes of infertility according to women’s age – a cross-sectional study in a tertiary healthcare hospital setup
  10. Supplementation of antihypertensive drug regimen with vitamin E ameliorates alterations of primary haemodynamic parameters and total antioxidant capacity in ovariectomised rats
  11. Analgesic effect of curcumin topical formulation in knee osteoarthritis patients: a clinical trial
  12. ProACT in the management of stress urinary incontinence after radical prostatectomy. What happens after 8 years of follow up? monocentric analysis in 42 patients
  13. The effect of metformin on the metabolism of human vascular smooth muscle cells in high glucose conditions
  14. Physiological response of endurance exercise as a growth hormone mediator in adolescent women’s
  15. Effect of Om chanting and Yoga Nidra on depression anxiety stress, sleep quality and autonomic functions of hypertensive subjects – a randomized controlled trial
  16. Effectiveness of electrical vestibular nerve stimulation as adjunctive therapy to improve the cognitive functions in patients with Parkinson’s disease
  17. Role of interleukin-22 in tuberculosis patients
  18. Effect of aspirin on the TNF-α-mediated cell survival and death pathways in breast cancer
  19. Resting heart rate variability as a diagnostic marker of cardiovascular dysautonomia in postural tachycardia syndrome
  20. Effects of intensity and training on cardiovascular responses to the Valsalva maneouvre
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