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Portal Hypertension: Extrahepatic Mechanisms

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Vascular Liver Disease

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Abstract

The primary event leading to portal hypertension in liver cirrhosis is increased hepatic resistance. However, portal hypertension induces marked alterations in the systemic and splanchnic circulation that result in an increase in portal blood inflow that maintains and aggravates portal hypertension. These include a decrease in systemic vascular resistance, arterial hypotension, increased cardiac output, and plasma volume expansion and are collectively known as the hyperdynamic circulatory state. This chapter provides an overview of the contribution of splanchnic and systemic circulatory abnormalities to the pathogenesis of portal hypertension.

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Authors and Affiliations

  1. Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic-Idibaps, University of Barcelona and Centro de Investigación Biomédica de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain

    Jaime Bosch

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  1. Jaime Bosch
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  2. Juan G. Abraldes
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Correspondence to Jaime Bosch .

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  1. Keck School of Medicine, Div. GI & Liver Diseases, University of Southern California, Los Angeles, 90033, California, USA

    Laurie D. DeLeve

  2. , Section of Digestive Diseases, Yale University School of Medicine, New Haven, 06520, Connecticut, USA

    Guadalupe Garcia-Tsao

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Bosch, J., Abraldes, J.G. (2011). Portal Hypertension: Extrahepatic Mechanisms. In: DeLeve, L., Garcia-Tsao, G. (eds) Vascular Liver Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-8327-5_7

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