Increased arterial compliance in decompensated cirrhosis.
OBJECTIVE
In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP).


METHODS
Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension in patients with biopsy-verified cirrhosis (Child-Turcotte classes A/B/C=10/15/6).


RESULTS
COMPart was significantly higher in cirrhotic patients (n=31) than in controls (n=10) (1.44 vs 1.00 x 10(-3) l/mmHg, p<0.01). It increased significantly through the Child-Turcotte classes A, B, and C (1.02, 1.47, and 2.1 x 10(-3) l/mmHg, respectively, p=0.03). The stroke volume did not change significantly with the severity of the disease, but pulse pressure decreased through class A, B, and C (79, 65, and 50 mmHg, respectively, p<0.01). COMPart was slightly, but significantly correlated to the circulating level of CGRP (r=0.34, p<0.05), and a substantial but inverse correlation was present to MAP (r= -0.63, p<0.002).


CONCLUSIONS
Elevated arterial compliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related to the level of arterial blood pressure. The altered static and dynamic functions of the arterial wall in cirrhosis may have implications for the circulatory and homoeostatic derangement, and potentially for therapy with vasoactive drugs.
Henriksen
J H
JH
Department of Clinical Physiology, Hvidovre Hospital, Denmark.
Møller
S
S
Schifter
S
S
Bendtsen
F
F
D000328:Adult; D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D015740:Calcitonin Gene-Related Peptide / Q000097:blood; D003187:Compliance; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008875:Middle Aged; D012016:Reference Values; D012720:Severity of Illness Index; D013318:Stroke Volume
D015740:Calcitonin Gene-Related Peptide