Hyperdynamic circulation in cirrhosis: a role for nitric oxide?

Lancet. 1991 Mar 30;337(8744):776-8. doi: 10.1016/0140-6736(91)91384-7.


Hypotension, low systemic vascular resistance, and a reduced sensitivity to vasoconstrictors are features of cirrhosis. These cardiovascular changes might be the result of increased synthesis of a vasodilator. Nitric oxide (NO), a potent vasodilator, is synthesised in and released from peripheral blood-vessels in man. Studies in animals indicate that bacterial endotoxin and cytokines induce NO synthase expression in vessel walls, with sustained NO release and consequent hypotension. Endotoxaemia is a common feature of cirrhosis; persistent induction of NO synthase may account for the associated haemodynamic changes.

MeSH terms

  • Amino Acid Oxidoreductases / antagonists & inhibitors
  • Amino Acid Oxidoreductases / biosynthesis*
  • Endothelium, Vascular / metabolism
  • Endotoxins / blood
  • Hemodynamics*
  • Humans
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / metabolism
  • Liver Cirrhosis / physiopathology*
  • Nitric Oxide / metabolism*
  • Nitric Oxide Synthase
  • Vasodilation / drug effects


  • Endotoxins
  • Nitric Oxide
  • Nitric Oxide Synthase
  • Amino Acid Oxidoreductases