Increased urotensin II plasma levels in patients with cirrhosis and portal hypertension.
OBJECTIVE
Vasodilatation--despite activation of endogenous vasoconstrictors--is pronounced in portal hypertension. We therefore investigated the role of Urotensin II (U II), a newly described peptide reported to be a vasoconstrictor in the central arterial compartment and a vasodilator in the splanchnic vasculature.


METHODS
U II immunoreactivity was measured in 50 patients with cirrhosis and in 15 healthy controls. U II levels were compared in portal venous and central venous blood of 30 patients immediately before transjugular intrahepatic porto-systemic stent shunt implantation.


RESULTS
U II levels (median, range, ng/ml) were significantly increased in cirrhotics (12.3, 1.6-41.4) compared to controls (3.6, 0.1-12.0; P<0.001). In patients with cirrhosis, U II levels were significantly higher in central venous (12.9, 2.5-41.4) than in portal venous blood (11.0, 0.6-31.9; P<0.005). U II levels were higher in ascitic than in non-ascitic patients (P<0.02). They correlated positively with the wedged hepatic venous pressure gradient (rho=0.34, P<0.005) and negatively with the mean arterial pressure (rho=-0.41; P<0.001).


CONCLUSIONS
Urotensin II formation is upregulated in patients with cirrhosis and portal hypertension. The transhepatic gradient suggests a hepatic production of this peptide.
Heller
Jörg
J
Department of Internal Medicine I, University of Bonn, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. jheller@uni-bonn.de
Schepke
Michael
M
Neef
Markus
M
Woitas
Rainer
R
Rabe
Christian
C
Sauerbruch
Tilman
T
D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology; D016022:Case-Control Studies; D002496:Central Venous Pressure; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012720:Severity of Illness Index; D015854:Up-Regulation; D014579:Urotensins / Q000097:blood*; D014690:Venous Pressure
D014579:Urotensins; C029677:urotensin II