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Vascular syndromes in liver cirrhosis
Journal article   Peer reviewed

Vascular syndromes in liver cirrhosis

Botros Shenoda and Joseph Boselli
Clinical journal of gastroenterology, v 12(5), pp 387-397
Oct 2019
DOI: https://doi.org/10.1007/s12328-019-00956-0
PMID: 30980261
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Collateral Circulation - physiology Hepatopulmonary Syndrome - etiology Hepatopulmonary Syndrome - physiopathology Hepatorenal Syndrome - etiology Hepatorenal Syndrome - physiopathology Humans Hypertension, Portal - etiology Hypertension, Pulmonary - etiology Hypertension, Pulmonary - physiopathology Liver Circulation - physiology Liver Cirrhosis - complications Liver Cirrhosis - physiopathology Pulmonary Circulation - physiology Splanchnic Circulation - physiology Syndrome Vascular Diseases - etiology Vascular Diseases - physiopathology Vasodilation - physiology
Liver cirrhosis is associated with multiple vascular syndromes affecting almost all body systems. Many of these syndromes are directly related to impaired liver function and sometimes reversible after liver transplantation while others arise secondary to portal hypertension and ascites. Altered expression of angiogenic and vasoactive compounds (most importantly nitric oxide), endothelial dysfunction, dysregulated neurohormonal control, and systemic inflammatory state play differential roles in mediating homeostatic instability and abnormal vasogenic response. Important vascular features encountered in liver disease include portal hypertension, splanchnic overflow, abnormal angiogenesis and shunts, portopulmonary syndrome, hepatopulmonary syndrome, and systemic hyperdynamic circulation. Redistribution of effective circulatory volume deviating from vital organs and pooling in splanchnic circulation is also encountered in liver patients which may lead to devastating outcomes as hepatorenal syndrome. Etiologically, vascular syndromes are not isolated phenomena and vascular dysfunction in one system may lead to the development of another in a different system. This review focuses on understanding the pathophysiological factors underlying vascular syndromes related to chronic liver disease and the potential links among them. Many of these syndromes are associated with high mortality, thus it is crucial to look for early biomarkers for these syndromes and develop novel preventive and therapeutic strategies.

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31 citations in Web of Science
32 citations in Scopus

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Web of Science research areas
Gastroenterology & Hepatology
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