Cirrhotic cardiomyopathy: A comprehensive review of pathophysiology, diagnosis, and management.
- 1Department of Gastroenterology, Jiujiang No. 1 People's Hospital, Jiujiang, Jiangxi, China.
- 2Department of Gastroenterology, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, Jiujiang, Jiangxi, China.
Abstract
Cirrhotic cardiomyopathy (CCM) is a prevalent yet frequently underrecognized cardiac complication of liver cirrhosis, characterized by impaired myocardial contractile reserve, diastolic dysfunction, and electrophysiological abnormalities. Despite its clinical significance, particularly in the setting of liver transplantation, CCM remains largely overlooked. We performed a narrative review of the literature on CCM published up to December 2025, covering pathophysiology, diagnostic criteria, imaging modalities, biomarkers, and management strategies. Depending on the diagnostic criteria used, the prevalence of CCM ranges from 29% to 67.2%. Advanced imaging techniques, particularly global longitudinal strain and cardiac magnetic resonance, enable early detection of subclinical systolic dysfunction. A "toxic triangle" comprising systemic inflammation, metabolic derangements, and neurohormonal activation represents an integrated pathophysiological model that drives myocardial fibrosis and dysfunction. Beta-blockers and aldosterone antagonists remain mainstays of pharmacological management, while liver transplantation is currently the only definitive therapy. CCM is an underrecognized condition with substantial clinical implications. Standardized diagnostic criteria, validated biomarkers, and large-scale prospective studies are urgently needed to improve patient outcomes.
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BibTeX
@article{zhang2026cirrhotic,
title = {{Cirrhotic cardiomyopathy: A comprehensive review of pathophysiology, diagnosis, and management.}},
author = {Li Zhang and Jing Yi},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051200},
url = {https://europepmc.org/article/MED/42888598},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Cirrhotic cardiomyopathy: A comprehensive review of pathophysiology, diagnosis, and management.
AU - Li Zhang
AU - Jing Yi
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051200
UR - https://europepmc.org/article/MED/42888598
AB - Cirrhotic cardiomyopathy (CCM) is a prevalent yet frequently underrecognized cardiac complication of liver cirrhosis, characterized by impaired myocardial contractile reserve, diastolic dysfunction, and electrophysiological abnormalities. Despite its clinical significance, particularly in the setting of liver transplantation, CCM remains largely overlooked. We performed a narrative review of the literature on CCM published up to December 2025, covering pathophysiology, diagnostic criteria, imaging modalities, biomarkers, and management strategies. Depending on the diagnostic criteria used, the prevalence of CCM ranges from 29% to 67.2%. Advanced imaging techniques, particularly global longitudinal strain and cardiac magnetic resonance, enable early detection of subclinical systolic dysfunction. A "toxic triangle" comprising systemic inflammation, metabolic derangements, and neurohormonal activation represents an integrated pathophysiological model that drives myocardial fibrosis and dysfunction. Beta-blockers and aldosterone antagonists remain mainstays of pharmacological management, while liver transplantation is currently the only definitive therapy. CCM is an underrecognized condition with substantial clinical implications. Standardized diagnostic criteria, validated biomarkers, and large-scale prospective studies are urgently needed to improve patient outcomes.
SN - 0304-5412
SN - 1536-5964
ER -