The liver and kidney in pulmonary hypertension and right heart failure. A, Acute ischemic hepatitis and congestive hepatopathy. Right inset, Centrilobular necrosis in ischemic hepatitis. Left inset, Chronic hepatic congestion with sinusoidal dilatation and portal fibrosis. B, Congestive nephropathy. Right inset, Low perfusion kidney injury caused by hypoperfusion and ischemia, demonstrating fibrosis (*), necrotic cells (arrowhead), and intraluminal debris. Left inset, Congestive nephropathy, characterized by interstitial edema, swollen tubule cells, and tubular compression. ALAT indicates alanine transaminase; AP, arterial pressure; ASAT, aspartate aminotransferase; CVP, central venous pressure; LDH, lactic acid dehydrogenase; and yGT, gamma-glutamyl transpeptidase.
Systemic Consequences of Pulmonary Hypertension and Right-Sided Heart Failure | Circulation (ahajournals.org)