High arterial compliance in cirrhosis is related to low adrenaline and elevated circulating calcitonin gene related peptide but not to activated vasoconstrictor systems

Background and aims-Static and dynamic functions of the wall of large arter ies are largely unknown in cirrhosis in vivo. The present study was underta ken to determine arterial compliance (COMPart) in relation to vasodilator a nd vasoconstricter systems in patients with cirrhosis. In addition, vasoact ivity was manipulated by inhalation of oxygen. Study population and methods-In 20 patients with alcoholic cirrhosis and 12 controls we determined COMPart (stroke volume relative to pulse pressure), cardiac output, plasma volume, systemic vascular resistance, central circu lation time, plasma catecholamines, renin activity, endothetin-1, and calci tonin gene related peptide (CGRP) at baseline and during oxygen inhalation. Results-COMPart was significantly increased in cirrhotic patients compared with centrals (1.32 upsilon 1.06 m1/mm Hg; p< 0.05) and inversely related t o plasma adrenaline levels (r=-0.53; p<0.02) but positively related to circ ulating levels of CGRP (r=0.58; p<0.01). No significant relation was found for plasma noradrenaline, renin activity, or endothelin-1. COMPart was posi tively related to plasma volume (r =0.50; p<0.02) and inversely to systemic vascular resistance (r=-0.69; p<0.001) and, central circulation time (r=-0 .49; p<0.02). During oxygen inhalation, COMPart decreased (-13%; p<0.005) a nd systemic vascular resistance increased (+10%; p<0.001)towards normal val ues without significant changes in mean arterial pressure. Plasma adrenalin e (-16%; p<0.01) decreased and the relation to COMPart disappeared. The rel ation of COMPart to CGRP and circulatory variables remained unchanged. Conclusion-Elevated arterial compliance in cirrhosis is related to low adre naline, high CGRP, and systemic hyperdynamics but not to indicators of the activated vasoconstrictor systems (noradrenaline, renin, endothelin-1). Thu s the altered static and dynamic characteristics of the wall of large arter ies are intimately associated with circulatory and vasodilatory derangement in cirrhosis but biomanipulation indicates that the changes are, at least in part, reversible during isobaric conditions.