Vascular deterioration in cirrhosis: the big picture

J Clin Gastroenterol. 2007 Nov-Dec:41 Suppl 3:S247-53. doi: 10.1097/MCG.0b013e3181572357.

Abstract

Cirrhosis is characterized by marked abnormalities in the hepatic circulation. Functionally, there is an increased vascular tone and impaired flow-mediated vasorelaxation, whereas anatomically there is sinusoidal remodeling and capillarization, angiogenesis, venous thrombosis, and vascular distortion, all contributing to increase hepatic vascular resistance and portal hypertension. However, vascular changes are not limited to the liver, but are also present in the splanchnic organs, heart, lungs, kidney, brain, and skin. Advances in the knowledge of the mechanisms of these abnormalities have disclosed new targets for therapy and ultimately improved survival.

Publication types

  • Review

MeSH terms

  • Animals
  • Antihypertensive Agents / therapeutic use
  • Cerebrovascular Circulation
  • Collateral Circulation
  • Coronary Circulation
  • Disease Progression
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / pathology
  • Endothelium, Vascular / physiopathology*
  • Extracellular Matrix / metabolism
  • Humans
  • Hypertension, Portal / etiology*
  • Hypertension, Portal / metabolism
  • Hypertension, Portal / pathology
  • Hypertension, Portal / physiopathology
  • Hypertension, Portal / therapy
  • Inflammation / physiopathology
  • Insulin Resistance
  • Liver / blood supply*
  • Liver / metabolism
  • Liver / pathology
  • Liver / physiopathology
  • Liver Circulation
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / metabolism
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / physiopathology*
  • Liver Cirrhosis / therapy
  • Neovascularization, Pathologic / physiopathology
  • Oxidative Stress
  • Portal Pressure
  • Pulmonary Circulation
  • Renal Circulation
  • Skin / blood supply
  • Splanchnic Circulation*
  • Treatment Outcome
  • Vascular Resistance
  • Vasodilation

Substances

  • Antihypertensive Agents