Doppler assessment of splanchnic arterial flow in patients with liver cirrhosis: Correlation with nitric oxide

Abstract

Introduction/aim: Nitric oxide (NO) is a key mediator which, paradoxically, regulates sinusoidal (intrahepatic) and systemic/splanchnic circulation. The main goal of this study was to measure NO and compare serum values of NO with flow data in visceral blood vessels of the liver, spleen, kidney and intestine in patients with cirrhosis. Material and methods: This prospective study included 80 patients with cirrhosis of the liver. Doppler ultrasonography was used to assess flow velocity and resistive index (RI) in the hepatic (HA), right (RRA), and left renal (LRA), splenic (SA) and superior mesenteric artery (SMA). NO concentration was determined using the DetectX® Nitric Oxide colorimetric detection kit. Results: We found a statistically significant difference in the mean NO value in the group of patients without ascites compared to the ascites group, as well as in the group of patients with A stage in relation to C stage of cirrhosis (p <0.05). There is statistically significant negative correlation between NO and diameter, and maximal and minimal velocity in LRA. There is significant positive correlation between NO and minimal velocity in SMA. Conclusions: In this study, we found that patients with cirrhosis of the liver were exposed to significantly higher RI LRA, RRA, SA and HA. In patients with cirrhosis complicated by ascites and in those with end stage liver disease, the NO level was significantly higher. The concentration of NO had an effect on the diameter and flow rate in the LRA and flow rate in SMA.