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2016 ; 10
(3
): 531-537
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Cirrhotic Cardiomyopathy: Another Case of a Successful Approach to Treatment of
Hepatorenal Syndrome
#MMPMID27843430
Mocarzel LO
; Bicca J
; Jarske L
; Oliveira T
; Lanzieri P
; Gismondi R
; Ribeiro ML
Case Rep Gastroenterol
2016[Sep]; 10
(3
): 531-537
PMID27843430
show ga
Hepatorenal syndrome (HRS) is defined as a failure of renal function, potentially
reversible, in patients with liver cirrhosis and ascites. Recently, a component
of cardiomyopathy associated with HRS was described, but the use of positive
inotropic medicine as part of the treatment of the acute phase has not been
extensively evaluated. We report a second case in our hospital of a patient with
HRS type I without previous heart disease, with secondary hemodynamic
decompensation due to liver disease, in which the abnormalities in systolic
function by speckle-tracking echocardiography were observed and could be reversed
by the use of inotropes. After partial response to current therapies, the patient
presented a clinical and laboratorial response with improvement of renal function
after infusion of dobutamine. Clinical studies are needed for the therapy
approach to HRS taking into account myocardial dysfunction as a major
contributing factor for renal dysfunction.