RELATION OF CALCITONIN-GENE-RELATED PEPTIDE TO SYSTEMIC VASODILATATION AND CENTRAL HYPOVOLEMIA IN CIRRHOSIS

Background: The aetiology of the reduced systemic vascular resistance and abnormal 'filling' of the vascular bed in cirrhosis is still obscu re. As increased concentrations of the potent vasodilator calcitonin g ene-related peptide (CGRP) have recently been reported in cirrhosis, w e related CGRP to central and peripheral haemodynamics in patients wit h cirrhosis. Methods: Thirty-one cirrhotic patients and six control su bjects underwent an investigation with determination of systemic haemo dynamics and circulating CGRP. Results: Circulating CGRP was significa ntly increased in patients with cirrhosis (P < 0.02) and covaried dire ctly with the severity of cirrhosis (P < 0.02). The increased CGRP cov aried negatively with the reduced systemic vascular resistance (P < 0. 02), the reduced central blood volume (P < 0.01), and reduced central circulation time (P < 0.002) and positively with the non-central blood volume (P < 0.05). Conclusions: These results suggest that increased CGRP may play a role in the systemic vasodilatation in cirrhosis and m ay contribute to the abnormal distribution of the blood volume, which may lead to abnormal sodium and water handling.