Premium
Role of the endothelium on vasoactive agents in patients with liver cirrhosis
Author(s) -
Battaglia Samuel,
Angus Peter,
ChinDusting Jaye PF
Publication year - 2006
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04451.x
Subject(s) - sodium nitroprusside , medicine , bradykinin , endocrinology , acetylcholine , cirrhosis , vasodilation , norepinephrine , prostacyclin , nitric oxide , dopamine , receptor
Background and Aim: Patients with liver cirrhosis exhibit peripheral vasodilatation and decreased vasoconstrictor responsiveness. We investigated the role of the endothelium in these patients. Methods: Nine patients with cirrhosis and seven controls were recruited. Responses to acetylcholine, bradykinin and sodium nitroprusside were obtained using forearm plethysmography. Responses to norepinephrine (100 ng/min) were obtained in the absence and combined presence of the cyclo‐oxygenase inhibitor, indomethacin, and the nitric oxide (NO) synthase inhibitor, N G ‐monomethyl‐L‐arginine. Results: Responses to acetylcholine (area under curve: controls vs cirrhotic, 10326 ± 1400 vs 18490 ± 2787 units; P = 0.036), but not to bradykinin (15619 ± 3557 vs 12415 ± 3823 units) or sodium nitroprusside, were significantly higher in patients with cirrhosis. Responses to norepinephrine were significantly dampened in cirrhotics (percentage increase in forearm blood flow; controls vs cirrhotics, −50.50 ± 2.69 vs −26.39 ± 5.44; P = 0.036) but this blunted response was no longer apparent following the administration of both blockers. Conclusions: We conclude that: (i) there is an increased response to acetylcholine but not to bradykinin; and (ii) that an enhanced production of prostacyclin and/or NO is responsible for the dampened response to norepinephrine.