ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 1 (2021), DIAGNOSTIC APPROACHES FOR CRITICAL CONDITIONS
No. 1 (2021)
DIAGNOSTIC APPROACHES FOR CRITICAL CONDITIONS

Pathogenesis and clinical significance of the hyperdynamic circulatory syndrome in liver cirrhosis. Review

Published 05.03.2021
M.L. Katsin
Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology, Minsk, Republic of Belarus
https://orcid.org/0000-0001-8129-1249
M.Y. Hurava
Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology, Minsk, Republic of Belarus
https://orcid.org/0000-0003-4923-7204
Pavel S. Prylutski
Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology, Minsk, Republic of Belarus
https://orcid.org/0000-0002-5274-2714
A.M. Dzyadz’ko
Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology, Minsk, Republic of Belarus
https://orcid.org/0000-0003-1965-1850
O.O. Rummo
Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology, Minsk, Republic of Belarus
https://orcid.org/0000-0001-7023-4767
#2021-1
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Keywords

Liver Cirrhosis
Hypertension, Portal
Liver Failure
Liver Transplantation
Ascites
Hepatorenal Syndrome
Hepatic Encephalopathy
Vasodilation

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1.
Katsin M.L., Hurava M.Y., Prylutski P.S., Dzyadz’ko A.M., Rummo O.O. Pathogenesis and clinical significance of the hyperdynamic circulatory syndrome in liver cirrhosis. Review. Annals of Critical Care. 2021;(1):123-133. doi:10.21320/1818-474X-2021-1-123-133
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Abstract

Portal hypertension is the major consequences of liver cirrhosis and is accompanied by pathologic increase in portal blood flow resistance. As portal hypertension develops that results in formation of vessel’s collaterals and arterial vasodilatation. Hyperdynamic alternations become more significant due to hyporesponsiveness to vasoconstrictors and increased shunts formation with autonomic neuropathy. This combination of liver failure and portal hypertension leads to the hyperdynamic circulatory state partly owing to simultaneous vasodilatation of splanchnic and peripheral arterial vessels. So hyperdynamic circulatory syndrome is a late complication of portal hypertension due to liver cirrhosis. The main features of hyperdynamic circulatory syndrome are high cardiac output, increased heart rate and total blood volume coupled with decreased total systemic vascular resistance. Some of these cardiovascular changes are reversible after liver transplantation what show pathophysiological significance of portal hypertension. In this paper, we aimed to review pathophysiology and features of hyperdynamic syndrome that are well-known and directly related to portal hypertension (varices, ascites, hepatic encephalopathy and hepatorenal syndrome), while others are more rare and therefore further investigations are necessary (portopulmonary hypertension, cirrhotic cardiomyopathy).
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