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Liver dysfunction and heart failure

      The relationship between the heart and the liver is well established.
      • Naschitz R.D.
      • Slobodin G.
      • Roger L.
      • Zucherman E.
      • Yeshurun D.
      Heart diseases affecting the liver and liver disease affecting the heart.
      Therefore, it is surprising that the pattern of liver dysfunction in heart failure has only been defined recently. Lau and colleagues
      • Lau G.T.
      • Tan H.C.
      • Krithrarides L.
      Type of liver dysfunction in heart failure and its relation to the severity of tricuspid regurgitation.
      reported in this journal that heart failure is characterized by a cholestatic liver enzyme profile with elevated serum alkaline phosphatase (SAP) and γ-glutamyl transferase (GGT). The severity of cholestasis correlated with degree of tricuspid incompetence, pulmonary hypertension, and left ventricular ejection fraction. The histopathologic characteristics of the liver in heart failure were also described, including hyperaemia and congestion of the centrolobular zone of the hepatic lobule and collagen deposition and fibrosis of the septa.
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