Hyperdynamic mesenteric circulation in cirrhosis: humoral or neural mechanism?

The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis

“…Similarly, it has been experimentally shown that atrophy of mesenteric sympathetic innervation contributes to splanchnic vasodilatation . Results of these experimental studies suggest that portal hypertension per se also activates central nervous mechanisms and that neural contribution is an essential factor for the development of hyperdynamic circulation . Recently, in a large patient population comprising 410 cirrhotic patients, we found by principal components analysis that a hyperdynamic circulation was independently associated with a higher hepatic venous pressure gradient, a higher HBF and presence of ascites .…”

“…Therefore, direct neural pathways from the gut and the liver to the brain seem to contribute to the hyperdynamic circulatory state. Similarly, it has been experimentally shown that atrophy of mesenteric sympathetic innervation contributes to splanchnic vasodilatation . Results of these experimental studies suggest that portal hypertension per se also activates central nervous mechanisms and that neural contribution is an essential factor for the development of hyperdynamic circulation .…”