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[Relationships between plasma concentrations of endothelin and the severity of liver cirrhosis]
M Hartleb1, P Kirstetter, R Moreau
1Laboratoire d'Hémodynamique Splanchnique, Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy.
Insights
Plasma endothelin concentrations are elevated in cirrhosis patients, particularly those with severe liver disease. This finding may help assess disease severity and related hemodynamic changes.
Area of Science:
- Cardiovascular Physiology
- Hepatology
- Endocrinology
Context:
- Conflicting results exist regarding plasma endothelin levels in cirrhosis.
- The relationship between endothelin and cirrhosis severity is understudied.
Purpose:
- To measure plasma endothelin concentrations in cirrhosis patients and controls.
- To investigate correlations between endothelin levels and liver disease severity, and splanchnic/systemic hemodynamics.
Summary:
- Plasma endothelin concentrations were significantly higher in cirrhosis patients compared to controls.
- Endothelin levels correlated with Pugh's score and hepatic venous pressure gradient, but not systemic hemodynamics.
Impact:
- Establishes a link between elevated endothelin and cirrhosis severity.
- Suggests endothelin as a potential biomarker for assessing liver disease progression and associated complications.
Objectives:
Results of studies on plasma endothelin concentrations in patients with cirrhosis are conflicting. Moreover, the relationships between plasma endothelin concentrations and the severity of cirrhosis have not yet been studied. The aim of this study was to measure plasma endothelin concentrations in controls and in patients with cirrhosis. In addition, this study examined the relationships between plasma endothelin concentrations, and the severity of liver disease, splanchnic and systemic hemodynamics.
Methods:
Plasma endothelin concentrations (in the hepatic vein and the right atria), hepatic venous pressures, arterial pressure, cardiac output, pulmonary pressures and plasma concentrations of sodium and creatinine were measured in 7 controls and 28 patients with cirrhosis.
Results:
Plasma endothelin concentrations in the hepatic vein and the right atria were significantly higher in patients with cirrhosis (18.9 +/- 2.9 and 20.2 +/- 3.1 pg/mL, respectively) than in controls (6.1 +/- 1.1 and 7.2 +/- 1.1 pg/mL, respectively). In these patients, hepatic venous plasma endothelin concentrations were significantly correlated with Pugh's score (r = 0.49), hepatic venous pressure gradient (r = -0.44), and plasma sodium concentrations (r = -0.46). No significant correlation was found between plasma endothelin concentrations and systemic hemodynamics.
Conclusion:
Plasma endothelin concentrations are increased in patients with cirrhosis. Moreover, this increase is more marked in patients with severe liver disease than in patients with no or moderate impairment of liver function.