title: Serum levels of soluble vascular cell adhesion molecule are related to hyperdynamic circulation in patients with liver cirrhosis.
abstract: 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.
authors.affiliation: CIBEREHD and Servicio de Aparato Digestivo, Sección de Hepatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. oreloia@hotmail.com
authors.forename: Oreste
authors.initials: O
authors.lastname: Lo Iacono
authors.forename: Diego
authors.initials: D
authors.lastname: Rincón
authors.forename: Ana
authors.initials: A
authors.lastname: Hernando
authors.forename: Cristina
authors.initials: C
authors.lastname: Ripoll
authors.forename: Maria Vega
authors.initials: MV
authors.lastname: Catalina
authors.forename: Magdalena
authors.initials: M
authors.lastname: Salcedo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Clemente
authors.forename: Judith
authors.initials: J
authors.lastname: Gomez
authors.forename: Oscar
authors.initials: O
authors.lastname: Nuñez
authors.forename: Ana
authors.initials: A
authors.lastname: Matilla
authors.forename: Rafael
authors.initials: R
authors.lastname: Bañares
mesh_terms: 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
chemical_list: D019010:Vascular Cell Adhesion Molecule-1