Hemodynamic abnormalities in systemic circulation as source of complications of portal hypertension in cirrhotic patients Marek Hartleb Medical Science Review - Hepatologia 2008; 8 78-86 aaICID: 862356
Article type: Review article
IC™ Value: 3.01
Abstract provided by Publisher
In patients with cirrhosis and portal hypertension the splanchnic vasodilatation is the principal pathology in systemic circulation. Progressive fall in peripheral vascular resistance is responsible for neurohormonal dysregulation, which is associated with activation of potent vasoconstrictor and sodium-retaing mechanisms. Peripheral vasodilatation, increased activity of sympathetic system and hypervolemia form a hyperdynamic circulation in both the systemic and pulmonary vascular bed. High-output state leads to portal cardiomyopathy affecting systolic and diastolic cardiac functions. Pulmonary dysfunction involves diffusing abnormalities with the development of the hepatopulmonary syndrome and less frequently portopulmonary hypertension. Late cirrhosis is associated with abnormalities in blood distribution resulting in coexistence of hyper- and hypo- perfused organs. Hypoperfused kidneys underlie functional renal failure (hepatorenal syndrome). Despite lack of specific therapy for cardiac and pulmonary complications of portal hypertension, pertinent constriction of splanchnic arterial vasculature prevents many disastrous effects of hyperdynamic circulation.