Increased arterial compliance in decompensated cirrhosis
Section snippets
Study population
The study population comprised 31 patients with cirrhosis referred for haemodynamic investigation in order to diagnose and quantify portal hypertension. All patients had biopsy-verified cirrhosis. The age range was 30–74 years, with an average age of 53 years. None of the patients had experienced recent gastrointestinal bleeding, had signs of alcoholic hepatitis, or had encephalopathy above grade I. All patients had abstained from alcohol for at least 1 week and had no withdrawal symptoms at
Results
The results of the haemodynamic measurements are summarised in Table 2. SVR decreased significantly through the Child-Turcotte classes (p=0.04). Both SBP and DBP decreased significantly with increasing severity of the disease (p=0.002 and p=0.025). As expected, wedged-to-free hepatic venous pressure was substantially elevated and increased somewhat with the severity of the disease.
SV was significantly higher in the patients with cirrhosis than in the controls (86±4.4 vs 71±4.7 ml, p<0.05), but
Discussion
The present study shows that compliance of the arterial tree is elevated in patients with cirrhosis. COMPart increases, whereas the pulse amplitude decreases, with increasing severity of cirrhosis. The COMPart is slightly but significantly related to the elevated circulating levels of the vasodilator peptide CGRP, and inversely related to the level of arterial blood pressure.
The concept of arterial compliance is complex 26., 27., 31., 32.. Thus, the static and dynamic wall characteristics of
Acknowledgements
This study was supported by The John and Birthe Meyer Foundation, The Tode Foundation and a research grant by the H:S (Copenhagen Hospital Corporation) Research Foundation.
The authors are grateful to Ms Hanne B. Hansen, Master of Science, for skilful handling of the database and to Ms Bente Henriksen, secretary, for typing the manuscript.
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