Cardiac dysfunction in cirrhosis.
In cirrhosis, cardiac symptoms and physical signs occur as the liver functions worsen. Cirrhosis is associated with hyperdynamic circulation and beta-adrenergic system activation responsible for the cardiovascular changes. The purpose of the present study was to explore the cardiovascular response to exercise in cirrhotic patients. A total of 20 patients (16 men, four women) with cirrhosis of hepatitis B or C without any cardiac dysfunction were included in the study. Ten people (eight men, two women) were enrolled in the control group. Plasma noradrenaline and adrenaline concentrations, blood pressures in supine and standing positions, exercise echocardiography and exercise radionuclide ventriculography were carried out. In cirrhotics, the exercise capacity was lower and also there was an impaired cardiovascular response to exercise with lower than expected peak heart rate without any cardiac dysfunction, which may have important clinical implications for the ability of these patients to withstand cardiovascular stress.