There are few studies of cardiac function in cirrhosis, although contractile function disorders found in nonalcoholic cirrhosis in animal models suggested that this is independent from alcohol intake. These issues are complicated by the fact that, alcohol use represents one of the commonest causes of both cirrhosis and cardiomyopathy. There are reasons to believe that cirrhosis per se may be associated with subtle contractile dysfunction. First, hyperkinetic circulatory changes may induce a high-output cardiac failure resembling a chronic volume overload of the heart. Second, cirrhosis is associated with high serum catecholamine levels, and long-term exposure to elevated catecholamines results in cardiomyopathy. Third, necropsy series of patients with alcoholic/nonalcoholic cirrhosis show similar cardiac pathologic findings: diffuse fibrosis, subendocardial edema, nuclear and cytoplasmic vacuolation.