The functional state of the endothelium in patients with viral hepatitis and liver cirrhosis

Aim. To study the functional state of endothelium in patients with chronic viral hepatitis and liver cirrhosis and impact of left and right ventricle diastolic malfunction and pulmonary hypertension on endothelial function. Methods. 74 patients with chronic viral hepatitis (group 1), 62 patients with cirrhosis (group 2) and 17 healthy volunteers were examined. Doppler echocardiography and brachial artery ultrasonography with endothelium-dependent vasodilation measurement were performed. Results. Endothelium-dependent vasodilatation was reduced in patients of the 1 stgroup (6.2%), and of the 2 ndgroup (2.2%) compared to the controls (13.8%, р <0.05). Sensitivity coefficient for the brachial artery was measured as 0.31 (0.19; 0.35) in patients with chronic viral hepatitis, 0.25 (0.09; 0.35) in patients with cirrhosis compared to 1.27 (0.72; 1.29) in control group, demonstrating the marked endothelial dysfunction in patients of the 1 stand 2 ndgroups (р <0.05). Moderate pulmonary hypertension was accompanied by a more pronounced endothelium-dependent vasodilation impairment in both groups (р <0.05). In patients with viral hepatitis, endothelial malfunction was less common (62%) compared with patients with liver cirrhosis (85%, p=0.002). Presence of left and right ventricle diastolic malfunction did not influence the endothelial function. Conclusion. In patients with viral hepatitis and cirrhosis, endothelium-dependent vasodilatation is affected depending on the severity of the disease and increased if pulmonary hypertension was present. Presence of left and right ventricle diastolic malfunction did not influence the endothelial function.

liver cirrhosis, viral hepatitis, pulmonary hypertension