Serum levels of soluble vascular cell adhesion molecule are related to hyperdynamic circulation in patients with liver cirrhosis.
BACKGROUND
In patients with liver cirrhosis, serum levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) have been associated with increasing fibrosis and are related to angiogenesis.


OBJECTIVE
To assess the possible correlation between sVCAM-1 and splanchnic and systemic haemodynamic and clinical staging of cirrhotic patients.


METHODS
We assessed, using immunoassays, the serum levels of sVCAM-1, in the peripheral and hepatic vein, in all consecutive patients with liver cirrhosis, who underwent a haemodynamic study as part of its routine clinical work-up.


RESULTS
We studied 86 patients [61 M/25 F; age 51.1 (8.3) years] with alcoholic (31) or viral (HBV:6, HCV:49) cirrhosis, 10 of them with hepatocellular carcinoma (Milan criteria). The mean follow-up was 391(187) days; 29 patients died or underwent transplantion during follow-up. A strong correlation in serum levels of sVCAM-1 was observed between the peripheral and the hepatic vein (r=0.8; P=0.0001). There was no correlation between levels of sVCAM-1 and hepatic venous pressure gradient. At univariate analysis, sVCAM-1 was inversely related with mean arterial pressure (r=-0.292; P=0.007), systemic vascular resistance (SVR) (r=-0.37; P=0.005) and serum sodium levels (r=-0.326; P=0.002). In multivariate linear regression only SVR remained as an independent variable associated to sVCAM-1. A correlation of sVCAM-1 with Child-Pugh scores, model for end-stage liver disease (MELD) and the clinical stage proposed in the Baveno IV consensus conference was also observed. Finally, patients who died or underwent transplantion during follow-up had significantly greater values of sVCAM-1 at baseline than those who did not [3505(1329) vs. 2488(1208) P=0.001].


CONCLUSIONS
This study supports a potential role of sVCAM-1 as a marker of hyperdynamic circulation, closely related to the different stage of liver cirrhosis.
Lo Iacono
Oreste
O
CIBEREHD and Servicio de Aparato Digestivo, Sección de Hepatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. oreloia@hotmail.com
Rincón
Diego
D
Hernando
Ana
A
Ripoll
Cristina
C
Catalina
Maria Vega
MV
Salcedo
Magdalena
M
Clemente
Gerardo
G
Gomez
Judith
J
Nuñez
Oscar
O
Matilla
Ana
A
Bañares
Rafael
R
D000328:Adult; D005260:Female; D006439:Hemodynamics; D006503:Hepatic Veins / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013152:Splanchnic Circulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*; D014690:Venous Pressure
D019010:Vascular Cell Adhesion Molecule-1