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Q J Med 2002; 95: 827-830
© 2002 Association of Physicians

Commentary

Hyperdynamic circulation in liver cirrhosis: not peripheral vasodilatation but ‘splanchnic steal’

D.E. Newby and P.C. HAYES1

From the Departments of Cardiology and 1 Medicine, University of Edinburgh, Royal Infirmary, Edinburgh, UK

The first 10% of the full text of this article appears below.


   Introduction
 
It is generally accepted that liver cirrhosis is associated with a hyperdynamic circulation and peripheral vasodilatation. The Oxford Textbook of Medicine describes the clinical features of ‘flushed extremities, bounding pulses and capillary pulsations' in cirrhosis,1 and a resting tachycardia and systemic hypotension, with experimental evidence of elevated cardiac output and reduced total systemic vascular resistance, confirm the existence of a hyperdynamic circulation. In 1988, Schrier and colleagues2 proposed the ‘peripheral arterial vasodilatation hypothesis' to account for this hyperdynamic circulation as well as the initiation of sodium and water retention in cirrhosis. Many subsequent theories have been expounded . . . [Full Text of this Article]


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