Content of Some Endothelium-Dependent Vasoactive Substances of Blood Plasma, Indicators of Renin-Aldosterone System, Natriuretic Hormone in Patients with Decompensated Liver Cirrhosis and their Dependence on the Severity Grade of Portal Hypertension

Introduction. The question of the relationship of endothelial dysfunction as a vasoconstrictor and vasodilator imbalance, indices of renin-aldosterone system and natriuretic hormone in the blood of the portal system in patients with liver cirrhosis sometimes serve as the subject of stormy scientific discussions with the wording ambiguous and sometimes contradictory conclusions. Therefore, the aim of our study was to determine the content of some endothelium-dependent vasoactive substances of blood plasma, parameters of renin-aldosterone system, natriuretic hormone in patients with decompensated liver cirrhosis and to identify their dependence on the severity of portal hypertension grade. Materials and methods. 80 cirrhotic patients with varying severity grades of portal hypertension, for whom inpatient examination and treatment in created Lviv Regional Hepatological Center of Lviv Regional Clinical Hospital were involved into the study. Also there were examined 20 healthy individuals, who formed the control group. For all the patients it was performed a comprehensive clinical-laboratory and instrumental examination of all the organs and systems according to the requirements of modern medicine and improved by us doppler-floumetric ultrasound examination of the abdominal cavity vessels, using our patented method. We determined the levels of endothelin-1, cyclic guanosine monophosphate, tumor necrotizing factor α, renin, aldosterone and natriuretic hormone - according to the standardized methodology. Results and discussion. In patients with decompensated liver cirrhosis there were observed intense increase of endothelin-1, cyclic guanosine monophosphate, tumor necrotizing factor α, renin, aldosterone and natriuretic hormone compared with the reference rates (p < 0.05), which allows us to consider them as one of the "markers" of the severity of chronic diffuse liver disease. Growth of the level of endothelium-dependent vasoactive substances, indices of renin-aldosterone system, natriuretic hormone in the blood plasma of patients are directly proportional to the severity of portal hypertension grade. This fact indicates, that they are the pathogenetic link in origin and play a key role in the increase of the severity of the leading syndrome of portal hypertension, which causes the worsening of the general state of these patients, leads to a significant decrease of life quality and its complications, including bleeding from varicose esophageal varices, are of the decisive prognostic value and is the leading cause of death of the hepatological patients. Conclusions. Determination of the concentration levels of endothelin-1, cyclic guanosine monophosphate, tumor necrotizing factor α, renin, aldosterone and plasma natriuretic hormone in patients with decompensated liver cirrhosis can serve as a reliable diagnostic subsidiary criteria for the detection of portal hypertension and as one of "markers" of the determination of its severity grade.