WordNet

a chronic disease interfering with the normal functioning of the liver; the major cause is chronic alcoholism (同)cirrhosis of the liver
of or relating to the heart; "cardiac arrest"
the opening into the stomach and that part of the stomach connected to the esophagus

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肝硬変
心臓の

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/14 03:08:47」(JST)

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Congestive hepatopathy, also known as nutmeg liver and chronic passive congestion of the liver, is liver dysfunction due to venous congestion, usually due to congestive heart failure. The gross pathological appearance of a liver affected by chronic passive congestion is "speckled" like a grated nutmeg kernel; the dark spots represent the dilated and congested hepatic venules and small hepatic veins. The paler areas are unaffected surrounding liver tissue. When severe and longstanding, hepatic congestion can lead to fibrosis; if congestion is due to right heart failure, it is called cardiac cirrhosis.^[1]

Signs and symptoms

Signs and symptoms depend largely upon the primary lesions giving rise to the condition. In addition to the heart or lung symptoms, there will be a sense of fullness and tenderness in the right hypochondriac region. Gastrointestinal catarrh is usually present, and vomiting of blood may occur. There is usually more or less jaundice. Owing to portal obstruction, ascites occurs, followed later by general dropsy. The stools are light or clay-colored, and the urine is colored by bile. On palpation, the liver is found enlarged and tender, sometimes extending several inches below the costal margin of the ribs.

Pathophysiology

Increased pressure in the sublobular branches of the hepatic veins causes an engorgement of venous blood, and is most frequently due to chronic cardiac lesions, especially those affecting the right heart, the blood being dammed back in the inferior vena cava and hepatic veins. Central regions of the hepatic lobules are red/brown and stand out against the noncongested, tan-coloured liver. Centrilobular necrosis occurs.

Macroscopically, the liver has a pale and spotty appearance in affected areas, as stasis of the blood causes pericentral hepatocytes (liver cells surrounding the central venule of the liver) to become deoxygenated compared to the relatively better-oxygenated periportal hepatocytes adjacent to the hepatic arterioles. This retardation of the blood also occurs in lung lesions, such as chronic interstitial pneumonia, pleural effusions, and intrathoracic tumors.

Treatment

Treatment is directed largely to removing the cause, or, where that is impossible, to modifying its effects. Thus, therapy aimed at improving right heart function will also improve congestive hepatopathy. True nutmeg liver is usually secondary to left-sided heart failure causing congestive right heart failure, so treatment options are limited.

References

^ Giallourakis CC, Rosenberg PM, Friedman LS (2002). "The liver in heart failure". Clin Liver Dis 6 (4): 947–67, viii–ix. doi:10.1016/S1089-3261(02)00056-9. PMID 12516201.

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1. うっ血肝 congestive hepatopathy
2. 肝酵素および肝機能検査値の異常が認められた患者に対するアプローチ approach to the patient with abnormal liver biochemical and function tests
3. 肝肥大：鑑別診断および評価 hepatomegaly differential diagnosis and evaluation
4. 嚢胞性線維症：肝胆道系疾患 cystic fibrosis hepatobiliary disease
5. 循環障害における肝障害の病因 pathogenesis of liver injury in circulatory failure

English Journal

L-arginine or tempol supplementation improves renal and cardiovascular function in rats with reduced renal mass and chronic high salt intake.

Carlström M, Brown RD, Yang T, Hezel M, Larsson E, Scheffer PG, Teerlink T, Lundberg JO, Persson AE.SourceDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
Acta physiologica (Oxford, England).Acta Physiol (Oxf).2013 Apr;207(4):732-41. doi: 10.1111/apha.12079. Epub 2013 Feb 25.
AIM: Early life reduction in nephron number and chronic high salt intake cause development of renal and cardiovascular disease, which has been associated with oxidative stress and nitric oxide (NO) deficiency. We investigated the hypothesis that interventions stimulating NO signalling or reducing ox
PMID 23387940

Chronic hyponatremia exacerbates multiple manifestations of senescence in male rats.

Barsony J, Manigrasso MB, Xu Q, Tam H, Verbalis JG.SourceDivision of Endocrinology and Metabolism, Georgetown University, Washington, DC, 20007, USA, jb394@georgetown.edu.
Age (Dordrecht, Netherlands).Age (Dordr).2013 Apr;35(2):271-88. doi: 10.1007/s11357-011-9347-9. Epub 2012 Jan 5.
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is frequently responsible for chronic hyponatremia in the elderly due to age-related disruption of the inhibitory component of brain osmoregulatory mechanisms. Recent research has indicated that chronic hyponatremia is associated w
PMID 22218780

Japanese Journal

肝硬変合併例に対する開心術 (特集合併症を有する胸部外科手術) -- (心臓血管領域)

松宮護郎
胸部外科 65(8), 640-643, 2012-07
NAID 40019384067

Changes in Cardiovagal Baroreflex Sensitivity Are Related to Increased Ventricular Mass in Patients With Liver Cirrhosis

Song Jun-Gol,Kim Young-Kug,Shin Won-Jung,Hwang Gyu-Sam
Circulation Journal 76(12), 2807-2813, 2012
… Background: Morphological and functional cardiac modifications attributable to neurohumoral activation and hyperdynamic circulation have been found in patients with liver cirrhosis (LC). … Conclusions: Reduced cardiovagal BRS is associated with increased LV mass in patients with LC, suggesting a relationship between cardiovagal BRS control of HR and cardiac end-organ damage in patients with cirrhotic cardiomyopathy. (Circ J 2012; …
NAID 130001870097

「cardiac」

Congestive hepatopathy
	Micrograph of congestive hepatopathy demonstrating perisinusoidal fibrosis and centrilobular (zone III) sinusoidal dilation. Liver biopsy. H&E stain.
Classification and external resources
ICD-10	K76.1
ICD-9-CM	573.8

　　[★]

adj.

心臓の、心の、心臓性、強心の

関: cardio、cardiotonic、heart、mind

「cirrhosis」

　　[★]

cirrho(=tawny yellow)

n.

肝硬変

[1] Giallourakis CC, Rosenberg PM, Friedman LS (2002). "The liver in heart failure". Clin Liver Dis 6 (4): 947–67, viii–ix. doi:10.1016/S1089-3261(02)00056-9. PMID 12516201.

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案内

案内

cardiac cirrhosis