title: Pathophysiology of portal hypertension.
abstract: Portal hypertension is a major complication of liver disease that results from a variety of pathologic conditions that increase the resistance to the portal blood flow into the liver. As portal hypertension develops, the formation of collateral vessels and arterial vasodilation progresses, which results in increased blood flow to the portal circulation. Hyperdynamic circulatory syndrome develops, leading to esophageal varices or ascites. This article summarizes the factors that increase (1) intrahepatic vascular resistance and (2) the blood flow in the splanchnic and systemic circulations in liver cirrhosis. In addition, the future directions of basic/clinical research in portal hypertension are discussed.
authors.affiliation: Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, 1080 LMP, 333 Cedar Street, New Haven, CT 06520, USA. Electronic address: yasuko.iwakiri@yale.edu.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Iwakiri
mesh_terms: D003097:Collateral Circulation; D042783:Endothelial Cells / Q000502:physiology; D055166:Hepatic Stellate Cells / Q000502:physiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology; D009389:Neovascularization, Pathologic; D013152:Splanchnic Circulation; D014655:Vascular Resistance; D014661:Vasoconstriction; D014664:Vasodilation
keywords: Cirrhosis; Fibrosis; Hyperdynamic circulation; Lymphatic system; Nitric oxide; Splenomegaly