Increased flow-mediated vasodilation in cirrhotic patients with ascites: relationship with renal resistive index

Liver Int. 2008 Dec;28(10):1396-401. doi: 10.1111/j.1478-3231.2008.01847.x. Epub 2008 Jul 29.


Background: Peripheral vasodilation is the key factor in the development of hyperdynamic circulation, sodium retention and functional renal failure in patients with cirrhosis. Brachial artery flow-mediated dilation (FMD) after transient vascular occlusion is a non-invasive method to assess the shear stress-induced arterial vasodilation.

Aims: To evaluate FMD in cirrhotic patients with and without ascites and to assess the relationship between FMD and intrarenal resistances.

Methods: Flow-mediated dilation was determined in 32 cirrhotic patients (22 with ascites) and 12 healthy controls and correlated with the intrarenal resistive index (RI) assessed by Doppler exploration.

Results: Basal diameter of the brachial artery was similar in healthy controls and in cirrhotic patients, whereas FMD was significantly higher in patients with cirrhosis and ascites [29.5% (range 10.3-50%)] than in pre-ascitic patients [17.3% (range 2.4-48.5%)] and healthy control subjects [11.6% (range 5.1-17.8%)] (P<0.001). Intrarenal RI was significantly higher in patients with cirrhosis than in healthy subjects, and a direct relationship existed between FMD and intrarenal RI (r=0.66; P<0.00001).

Conclusions: These findings in vivo demonstrate that cirrhotic patients with ascites have an enhanced shear stress-induced peripheral vasodilation, which is closely related to intrarenal vasoconstriction.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ascites / physiopathology
  • Blood Pressure
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiology*
  • Heart Rate
  • Humans
  • Laser-Doppler Flowmetry
  • Liver Cirrhosis / physiopathology*
  • Regional Blood Flow / physiology*
  • Renal Circulation / physiology*
  • Statistics, Nonparametric
  • Ultrasonography
  • Vasodilation / physiology*