Unifying Concepts

Diagnostic Criteria for Cardiac Hepatopathy

Cardiac hepatopathy, hepatic injury caused by cardiac dysfunction, is a common entity but has been characterized incompletely, particularly the relationship between hemodynamics and histology.

Diagnostic Criteria for Cardiac Hepatopathy
1- A liver biopsy compatible with cardiac hepatopathy
2- At least one of the following abnormal hemodynamic measurements:

  • right atrial pressure (RAP) greater than 10 mm Hg
  • mean pulmonary arterial pressure greater than 25 mm Hg
  • pulmonary capillary wedge pressure greater than 15 mm Hg
  • cardiac index less than 2.2 L/min  m2

3- Clinically overt circulatory shock or congestive heart failure.
Additional causes of liver disease including hepatitis B infection, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, hemochromatosis, Wilson disease, and 1-antitrypsin deficiency should be excluded.
Patients with excessive alcohol consumption (30 g/d in women and 50 g/d in men) also should be excluded.



  1. Myers RP, Cerini R, Sayegh R, Moreau R, Degott C, Lebrec D, Lee SS. Cardiac hepatopathy: clinical, hemodynamic, and histologic characteristics and correlations. Hepatology. 2003 Feb;37(2):393-400. [Medline]


Created Aug 25, 2011

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