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Increased flow‐mediated vasodilation in cirrhotic patients with ascites: relationship with renal resistive index
Author(s) -
Cazzaniga Massimo,
Salerno Francesco,
Visentin Stefania,
Cirello Ilaria,
Donarini Cesare,
Cugno Massimo
Publication year - 2008
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2008.01847.x
Subject(s) - medicine , ascites , hyperdynamic circulation , vasodilation , brachial artery , cirrhosis , cardiology , vasoconstriction , renal circulation , kidney , gastroenterology , portal hypertension , renal blood flow , blood pressure
Background: Peripheral vasodilation is the key factor in the development of hyperdynamic circulation, sodium retention and functional renal failure in patients with cirrhosis. Brachial artery flow‐mediated dilation (FMD) after transient vascular occlusion is a non‐invasive method to assess the shear stress‐induced arterial vasodilation. Aims: To evaluate FMD in cirrhotic patients with and without ascites and to assess the relationship between FMD and intrarenal resistances. Methods: Flow‐mediated dilation was determined in 32 cirrhotic patients (22 with ascites) and 12 healthy controls and correlated with the intrarenal resistive index (RI) assessed by Doppler exploration. Results: Basal diameter of the brachial artery was similar in healthy controls and in cirrhotic patients, whereas FMD was significantly higher in patients with cirrhosis and ascites [29.5% (range 10.3–50%)] than in pre‐ascitic patients [17.3% (range 2.4–48.5%)] and healthy control subjects [11.6% (range 5.1–17.8%)] ( P <0.001). Intrarenal RI was significantly higher in patients with cirrhosis than in healthy subjects, and a direct relationship existed between FMD and intrarenal RI ( r =0.66; P <0.00001). Conclusions: These findings in vivo demonstrate that cirrhotic patients with ascites have an enhanced shear stress‐induced peripheral vasodilation, which is closely related to intrarenal vasoconstriction.