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Nitric-oxide-mediated vasodilation and portal hypertension

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Portal Hypertension in the 21st Century

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Abstract

Chronic portal hypertension is associated with reduced splanchnic vascular arteriolar resistance and increased portal venous inflow. This hyperdynamic splanchnic circulatory state is accompanied by a hyperdynamic systemic circulation characterized by a low systemic vascular resistance with decreased arterial pressure and an increased cardiac output/index and regional organ blood flow 1. Arterial vasodilation represents the initiating mechanism and hence, pathophysiological hallmark, in the development of this hyperdynamic circulation. It occurs early and most predominantly in the splanchnic circulation. Vasodilation can be considered an expression of anatomical (portal-systemic collaterals) or functional (liver cell necrosis/intrahepatic shunts) liver failure, or both. Thus, it is not surprising to find the extent of vasodilation being an excellent prognostic indicator in cirrhotic patients 2.

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  1. Department of Internal Medicine I, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg, Germany

    R. Wiest

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  1. Yale University School of Medicine, New Haven, CT, USA

    R. J. Groszmann

  2. Hepatic Hemodynamic Laboratory Liver Unit, Hospital Clinic, University of Barcelona, Spain

    J. Bosch

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Wiest, R. (2004). Nitric-oxide-mediated vasodilation and portal hypertension. In: Groszmann, R.J., Bosch, J. (eds) Portal Hypertension in the 21st Century. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1042-9_8

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  • DOI: https://doi.org/10.1007/978-94-007-1042-9_8

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