Flow Mediated Dilation in Cirrhosis: A Pilot Study in Different Stages of the Disease

ARMENTANO, R.L.; ARBEITMAN, C.R.; CYMBERKNOP, L.J.; FARRO, I.; VIOTTI, R.; CARDELINO, J.

Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS

Institute of Electrical and Electronics Engineers Inc.

Año: 2018 vol. 2018 p. 4564 - 4566

1557-170X

Introduction: Cirrhosis is associated with changes in the cardiovascular system, where the circulatory dysfunction is compensated by the development of a hyperdynamic circulation. Endothelial function can be understood as the endothelium capability to release Nitric Oxide (NO) where an impairment in the normal development of this process constitutes a main step in the genesis and progression of atherosclerosis, a major cause of cardiovascular events. In recent years, non-invasive measurements have gained attention, due to the potential complications associated to invasive procedures. Objective: To evaluate endothelial function (EF) in patients with cirrhosis, in different stages of the disease, complemented with hemodynamic measurements. Methods: Individuals were divided in three age groups, according to the severity of their disease. EF was assessed by using the flow mediated dilation technique (FMD), jointly with noninvasive determination of cardiac output (CO), total peripheral resistance (TPR) and arterial compliance (AC). Results: TPR showed a decrease in advanced severity while AC had an increase. Particularly, EF was found to be higher in CHC group, decreasing in CHB and more pronounceably in CHA. Concomitantly, an inverse behavior was observed regarding CO evolution. Conclusion: EF was noninvasively evaluated in cirrhosis, in terms of the progression of the disease. Hyperdynamic states in the more advanced condition were accompanied by a higher vascular reactivity, probably associated with higher peripheral NO release and increased AC.