Liver cirrhosis and arterial hypertension

Table 1 Haemodynamics in central and peripheral vascular beds in patients with cirrhosis

Heart
Heart rate ↑
Cardiac output ↑
Left atrial volume ↑
Left ventricular volume → (↑)
Left ventricular end-diastolic pressure →
Right atrial volume →↑↓
Right atrial pressure →↑
Right ventricular volume →↑↓
Right ventricular end-diastolic pressure →
Systemic circulation
Plasma volume ↑
Total blood volume ↑
Central and arterial blood volume ↓ (→)
Noncentral blood volume ↑
Arterial blood pressure ↓ (→)
Systemic vascular resistance ↓
Arterial compliance ↑
Total vascular compliance ↑
Pulmonary circulation
Pulmonary blood flow ↑
Pulmonary artery pressure →↑
Pulmonary vascular resistance ↓ (↑)
Skeletal and cutaneous muscle circulation
Skeletal muscular blood flow ↑→↓
Cutaneous blood flow ↑→↓
Hepatic and splanchnic circulation
Hepatic blood flow ↑→ (↑)
Hepatic venous pressure gradient ↑
Renal circulation
Renal blood flow ↓
Glomerular filtration rate ↓→

↑, increase; →, no change; ↓, decrease. Parentheses denote minor changes.

Table 2 Haemodynamics and neuroendocrine mechanisms in patients with cirrhosis and different types of arterial hypertension

	Cirrhosis	Cirrhosis withhypertension	Essentialhypertension	Renovascularhypertension
Plasma and blood volume	↑	↑	→	→
Central blood volume	→↓	→↓	→(↑)	→(↑)
Systemic vascular resistance	↓	→	↑	↑
Arterial compliance	↑	→	↓	↓
Renal blood flow	↓	↓→	↓	↓
Sodium retention	↑	↑	→↑	↑
Sympathetic nervous activity	↑↑	↑	→	→↑
Renin–angiotensin– aldosterone system	↑↑	↑→	→↓	↑
Vasopressin	↑		→	→

→↑↓, denote normal, increased, and decreased values, resp-ectively; parentheses denote minor changes.

Table 3 Effects of propranolol, diuretics, terlipressin, and albumin on pressures, vascular resistance, vascular compliance, blood flow, blood volume distribution, portal pressure, and sodium excretion in patients with cirrhosis

	Non-selective beta-blocker	Diuretics	Terlipressin	Albumin
Arterial blood pressure	(↓)	(↓)	↑	→
Systemic vascular resistance	↑↑		↑↑	↓
Arterial compliance	→	→	↓	↑→
Total effective vascular compliance		↓→
Cardiac output	↓↓	↓	↓	↑
Central and arterial blood volume	→	(↓)	↑	↑→
Plasma volume	→	↓	↓	↑
Hepatic venous pressure gradient	↓→	↓	↓	→
Urinary sodium excretion	→	↑	↑	↑

→↑↓, denote normal, increased, and decreased values, res-pectively. Parentheses denote minor changes.