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The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis.
Liver Int. 2018 04; 38(4):570-580.LI

Abstract

Patients with cirrhosis and portal hypertension often develop complications from a variety of organ systems leading to a multiple organ failure. The combination of liver failure and portal hypertension results in a hyperdynamic circulatory state partly owing to simultaneous splanchnic and peripheral arterial vasodilatation. Increases in circulatory vasodilators are believed to be due to portosystemic shunting and bacterial translocation leading to redistribution of the blood volume with central hypovolemia. Portal hypertension per se and increased splanchnic blood flow are mainly responsible for the development and perpetuation of the hyperdynamic circulation and the associated changes in cardiovascular function with development of cirrhotic cardiomyopathy, autonomic dysfunction and renal dysfunction as part of a cardiorenal syndrome. Several of the cardiovascular changes are reversible after liver transplantation and point to the pathophysiological significance of portal hypertension. In this paper, we aimed to review current knowledge on the pathophysiology of arterial vasodilatation and the hyperdynamic circulation in cirrhosis.

Authors+Show Affiliations

Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging and Research, University of Copenhagen, Copenhagen, Denmark.Gastro Unit, Medical Division, Faculty of Health Sciences, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

28921803

Citation

Møller, Søren, and Flemming Bendtsen. "The Pathophysiology of Arterial Vasodilatation and Hyperdynamic Circulation in Cirrhosis." Liver International : Official Journal of the International Association for the Study of the Liver, vol. 38, no. 4, 2018, pp. 570-580.
Møller S, Bendtsen F. The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis. Liver Int. 2018;38(4):570-580.
Møller, S., & Bendtsen, F. (2018). The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis. Liver International : Official Journal of the International Association for the Study of the Liver, 38(4), 570-580. https://doi.org/10.1111/liv.13589
Møller S, Bendtsen F. The Pathophysiology of Arterial Vasodilatation and Hyperdynamic Circulation in Cirrhosis. Liver Int. 2018;38(4):570-580. PubMed PMID: 28921803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis. AU - Møller,Søren, AU - Bendtsen,Flemming, Y1 - 2018/01/15/ PY - 2017/07/25/received PY - 2017/09/11/accepted PY - 2017/9/19/pubmed PY - 2019/1/8/medline PY - 2017/9/19/entrez KW - cardiac dysfunction KW - liver failure KW - multi-organ syndrome KW - portal hypertension SP - 570 EP - 580 JF - Liver international : official journal of the International Association for the Study of the Liver JO - Liver Int VL - 38 IS - 4 N2 - Patients with cirrhosis and portal hypertension often develop complications from a variety of organ systems leading to a multiple organ failure. The combination of liver failure and portal hypertension results in a hyperdynamic circulatory state partly owing to simultaneous splanchnic and peripheral arterial vasodilatation. Increases in circulatory vasodilators are believed to be due to portosystemic shunting and bacterial translocation leading to redistribution of the blood volume with central hypovolemia. Portal hypertension per se and increased splanchnic blood flow are mainly responsible for the development and perpetuation of the hyperdynamic circulation and the associated changes in cardiovascular function with development of cirrhotic cardiomyopathy, autonomic dysfunction and renal dysfunction as part of a cardiorenal syndrome. Several of the cardiovascular changes are reversible after liver transplantation and point to the pathophysiological significance of portal hypertension. In this paper, we aimed to review current knowledge on the pathophysiology of arterial vasodilatation and the hyperdynamic circulation in cirrhosis. SN - 1478-3231 UR - https://www.unboundmedicine.com/medline/citation/28921803/The_pathophysiology_of_arterial_vasodilatation_and_hyperdynamic_circulation_in_cirrhosis_ DB - PRIME DP - Unbound Medicine ER -