LIVER MANIFESTATIONS IN CHRONIC HEART FAILURE: CLINICAL IMPLICATIONS AND SURGICAL STRATEGIES IN HEART CIRRHOSIS

Abstract

Introduction: Chronic heart failure is a progressive condition that often results in hepatic manifestations, most notably cardiac cirrhosis. This condition occurs when chronic venous congestion secondary to heart failure leads to liver dysfunction, causing a series of changes that affect liver function and the patient's general health. Women, in particular, may be more susceptible to complications due to physiological and hormonal differences. Clinical implications include increased risk of morbidity and mortality, in addition to the need for surgical interventions in advanced cases, such as liver transplantation or procedures that relieve congestion. Objective: To analyze hepatic manifestations in chronic heart failure, emphasizing the clinical implications and surgical strategies in cardiac cirrhosis. Methodology: The methodology used the PRISMA checklist to ensure the quality of study selection. The databases consulted were PubMed, Scielo and Web of Science, using the descriptors Right heart failure, Venous congestion, Hepatic fibrosis, Central venous pressure, Hepatic veins. Inclusion criteria were: studies discussing hepatic manifestations in heart failure, publications from the last 10 years, and including data on women. Articles that did not focus on cardiac cirrhosis, literature reviews, and studies in pediatric populations were excluded. Results: The results indicated that hepatic manifestations, such as hepatomegaly and hepatopulmonary syndrome, are common in chronic heart failure and can exacerbate the patient's condition. Surgical management in cases of cardiac cirrhosis is challenging, but may include management of portal hypertension and consideration for liver transplantation in selected patients. The literature highlighted that careful evaluation and surgical planning are essential to improve outcomes. Conclusion: Hepatic manifestations in chronic heart failure represent a significant complication, requiring a comprehensive clinical approach and appropriate surgical strategies. The review highlighted the importance of personalized management, especially for women, aiming to improve quality of life and clinical outcomes in patients with cardiac cirrhosis.