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首页> 外文期刊>World Journal of Gastroenterology >Cardiac and vascular changes in cirrhosis: Pathogenic mechanisms.
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Cardiac and vascular changes in cirrhosis: Pathogenic mechanisms.

机译:肝硬化的心脏和血管变化:致病机制。

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摘要

Cardiovascular abnormalities accompany both portal hypertension and cirrhosis. These consist of hyperdynamic circulation, defined as reduced mean arterial pressure and systemic vascular resistance, and increased cardiac output. Despite the baseline increased cardiac output, ventricular inotropic and chronotropic responses to stimuli are blunted, a condition known as cirrhotic cardiomyopathy. Both conditions may play an initiating or aggravating pathogenic role in many of the complications of liver failure or portal hypertension including ascites, variceal bleeding, hepatorenal syndrome and increased postoperative mortality after major surgery or liver transplantation. This review briefly examines the major mechanisms that may underlie these cardiovascular abnormalities, concentrating on nitric oxide, endogenous cannabinoids, central neural activation and adrenergic receptor changes. Future work should address the complex interrelationships between these systems.
机译:心血管异常伴随门脉高压和肝硬化。这些包括高动力循环,定义为平均动脉压降低和全身血管阻力降低,以及心输出量增加。尽管基线心输出量增加,但对刺激的心室变力和变时反应却减弱了,这种情况被称为肝硬化性心肌病。在肝衰竭或门脉高压的许多并发症中,包括腹水,静脉曲张破裂出血,肝肾综合征和大手术或肝移植术后死亡率增加,两种情况都可能起病或加重病原学作用。这篇综述简要地检查了可能是这些心血管异常的潜在主要机制,重点是一氧化氮,内源性大麻素,中枢神经激活和肾上腺素能受体的改变。未来的工作应该解决这些系统之间的复杂相互关系。

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