Hyperdynamic circulation in patients with cirrhosis: direct measurement of nitric oxide levels in hepatic and portal veins

Pulmonary–Hepatic vascular Disorders (PHD)

“…noradrenalin, rennin-angiotensin-aldosterone and arginine vasopressin) and vasodilators (i.e. NO, glucagon, vasoactive peptide and substance P) have been measured in the setting of portal hypertension [186][187][188]. In short, investigators have hypothesised that an imbalance of vasoactive substances could reach the pulmonary circulation in abnormally high concentrations due to portosystemic shunts or defective hepatic metabolism, causing the pathological pulmonary vascular lesions seen in PPHTN [6,153].…”

Hepatorenal Syndrome

“…Patients with cirrhosis and ascites have higher NO plasma concentrations than normal individuals or those with compensated cirrhosis, and high serum NO level correlates with high plasma RAAS activity and antidiuretic hormone levels as well as low urinary sodium excretion (57,58). The concentration of NO is higher in portal venous plasma than in peripheral venous plasma, suggesting increased splanchnic production of NO (59). Although there is enthusiasm for a role for NO in peripheral vasodilation, there still is a controversy about whether NO is the primary factor in the genesis and maintenance of the hyperdynamic circulation (60).…”

Evidence of an increased nitric oxide production in primary biliary cirrhosis

“…Besides reactive oxygen intermediates, human neutrophils have been demonstrated to be capable of synthesizing and releasing nitric oxide (NO) (15,16), a versatile multifunctional molecule acting as both a protective and a toxic mediator (17,18). Its production has been hypothesized to be altered in different pathophysiological conditions of the liver, such as cirrhosis and its complications (19,20).…”