DOPPLER ASSESSMENT OF SPLANCHNIC ARTERIAL FLOW IN PATIENTS WITH LIVER CIRRHOSIS: CORRELATION WITH NITRIC OXIDE

  • Tijana Glisic Clinic for Gastroenterohepatology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Dusan Popovic Clinic for Gastroenterohepatology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Milica Stojkovic Lalosevic Clinic for Gastroenterohepatology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Jelena Martinov Clinic for Gastroenterohepatology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Marija Stojanovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Vladimir Jurisic Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
DOI: https://doi.org/10.5937/medi55-41696
Keywords: liver cirrhosis, nitric oxide, Doppler ultrasonography

Abstract


Introduction/aim: Nitric oxide (NO) is a key mediator who, paradoxically, regulated sinusoidal (intrahepatic) and system/splanchnic circulation. The main goal of this study were measurement of NO, comparison of serum values of NO with flow data in visceral blood vessels of the liver, spleen, kidney and intestine in patients with cirrhosis.

Material and methods: This prospective study included 80 patients with liver cirrhosis. Doppler ultrasonography was used to assess flow velocity and resistive index (RI) in the hepatic (HA), right (RRA), and left renal (LRA), splenic (SA) and superior mesenteric artery (SMA). NO concentration was determined using the DetectX® Nitric Oxide colorimetrically detection kit.

Results: We find a statistically significant difference in the mean NO value in the group of patients without ascites compared to the ascites group, and also  in the group of patients with A stage in relation to the C stage of liver cirrhosis (p <0.05). There is statistically significant negative correlation between NO and diameter, and maximal and minimal velocity in LRA.  There is significant positive correlation between NO and minimal velocity in SMA.

Conclusions: In this study, we found that patients with liver cirrhosis were exposed to significantly higher RI LRA, RRA, SA and HA. In patients with cirrhosis complicated by ascites and in those with end stage liver disease, the NO level was significantly higher. The concentration of NO has an effect on the diameter and flow rate in the LRA and flow rate in SMA.

Published
2023/03/20
Issue
Vol. 56 No. 1 (2023): Medicinska istraživanja
Section
Članci