Table 1 Circulatory changes in specific vascular beds in cirrhosis
Systemic circulation
    Plasma volume ↑
    Total blood volume ↑
    Non-central blood volume ↑
    Central and arterial blood volume ↓ (→)
    Arterial blood pressure ↓ (→)
    Systemic vascular resistance ↓
Cutaneous and skeletal muscle circulation
    Skeletal muscular blood flow* ↑ → ↓
    Cutaneous blood flow* ↑ → ↓
Heart
    Heart rate ↑
    Cardiac output ↑
    Left atrial volume ↑
    Left ventricular volume → (↑)
    Right atrial volume → ↑ ↓
    Right atrial pressure → ↑
    Right ventricular end-diastolic pressure →
    Pulmonary artery pressure → ↑
    Pulmonary capillary wedge pressure →
    Left ventricular end-diastolic pressure →
    Total vascular compliance ↑
    Arterial compliance ↑
Hepatic and splanchnic circulation
    Hepatic blood flow† ↓ → (↑)
    Hepatic venous pressure gradient ↑
    Postsinusoidal resistance ↑
Renal circulation
    Renal blood flow ↓
    Glomerular filtration rate (↑)↓ →
Cerebral circulation
    Cerebral blood flow ↓→
Pulmonary circulation
    Pulmonary blood flow ↑
    Pulmonary vascular resistance ↓ (↑‡)
    Pulmonary blood volume ↓
    Pulmonary transit time ↓
  • ↑ → ↓ denote: increased, unchanged and decreased, respectively. Arrows in parentheses describe early/less typical changes.

  • *Available data are highly dependent on the applied technique.

  • †Changes in intrahepatic blood flow due to variable co-determination of portosystemic shunts.

  • ‡Increased in portopulmonary hypertension.