Vascular deterioration in cirrhosis: the big picture.
Cirrhosis is characterized by marked abnormalities in the hepatic circulation. Functionally, there is an increased vascular tone and impaired flow-mediated vasorelaxation, whereas anatomically there is sinusoidal remodeling and capillarization, angiogenesis, venous thrombosis, and vascular distortion, all contributing to increase hepatic vascular resistance and portal hypertension. However, vascular changes are not limited to the liver, but are also present in the splanchnic organs, heart, lungs, kidney, brain, and skin. Advances in the knowledge of the mechanisms of these abnormalities have disclosed new targets for therapy and ultimately improved survival.
Bosch
Jaime
J
Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic-Idibaps, University of Barcelona and Centro de Investigación Biomédica de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain. jbosch@clinic.ub.es
D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002560:Cerebrovascular Circulation; D003097:Collateral Circulation; D003326:Coronary Circulation; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D005109:Extracellular Matrix / Q000378:metabolism; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D007249:Inflammation / Q000503:physiopathology; D007333:Insulin Resistance; D008099:Liver / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D009389:Neovascularization, Pathologic / Q000503:physiopathology; D018384:Oxidative Stress; D017082:Portal Pressure; D011652:Pulmonary Circulation; D012079:Renal Circulation; D012867:Skin / Q000098:blood supply; D013152:Splanchnic Circulation; D016896:Treatment Outcome; D014655:Vascular Resistance; D014664:Vasodilation
D000959:Antihypertensive Agents