[Progress in portal hypertension].
In patients with portal hypertension due to cirrhosis, the mechanisms responsible for circulatory modifications are well-known. An elevation in intrahepatic vascular resistance related to a hepatic endothelin hyperproduction and an arterial nitric oxide (NO) hyperproduction. The presence and the degree of portal hypertension might be determined by the measurement of the hepatic venous pressure gradient but non-invasive technique as FibroTest or FibroScan might be useful to estimate the presence of severe portal hypertension. Numerous substances decrease portal pressure either by reducing hepatic vascular resistance or by reducing portal tributary blood flow. The combination of both types of substances is probably the best pharmacological treatment of portal hypertension but further hemodynamic and clinical studies are needed.
Lebrec
D
D
Inserm U773, Centre de Recherche Bichat-Beaujon CRB3, 75018 Paris, France. didier.lebrec@inserm.fr
Moreau
R
R
D000818:Animals; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014655:Vascular Resistance / Q000187:drug effects