Abstract
Cirrhosis of the liver is among the most prevalent diseases in Western countries. The prognostic expectations for these patients are grim, except for those who may benefit from liver transplantation. This is due to the multiple organic derangement, including renal failure, variceal bleeding or bacterial peritonitis, developed by these individuals1. Several clinical and experimental studies have demonstrated that the trigger for these disturbances is the existence of an important and progressively accentuated cardiocirculatory dysfunction of which portal hypertension, arterial hypotension, high cardiac output and diminished systemic vascular resistance are the most relevant features2. Thus, during the past decade the mechanisms leading to decreased arterial pressure and concomitant arterial vasodilation in cirrhosis have been a subject of great interest. Moreover, vasodilation seems to be localized in the splanchnic circulation because direct blood flow and/or resistive index measurements in skin, skeletal muscle or extremities have found normal or even elevated values of these parameters in cirrhotic patients3, 4. Although it is generally believed that increased endothelial production of nitric oxide (NO) by the splanchnic vasculature is of major importance in the pathogenesis of this phenomenon5, other mechanisms are probably implicated.
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Jimënez, W., Ros, J. (2004). Endogenous cannabinoids and circulatory dysfunction in cirrhosis. In: Groszmann, R.J., Bosch, J. (eds) Portal Hypertension in the 21st Century. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1042-9_11
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DOI: https://doi.org/10.1007/978-94-007-1042-9_11
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-3774-7
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