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Observational study of the microcirculation in patients with liver cirrhosis

Wythe, S; Davies, TW; O'Beirne, J; Martin, D; Gilbert‐Kawai, E; (2019) Observational study of the microcirculation in patients with liver cirrhosis. JGH Open 10.1002/jgh3.12196. (In press). Green open access

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Abstract

Background and Aim: Liver cirrhosis is associated with widespread microcirculatory dysfunction and hemodynamic derangement, which may play a role in the pathogenesis of multiple organ failure. Little is known, however, about the progression of microvascular alterations as the severity of liver disease worsens. Therefore, our aim is to quantify the peripheral systemic microcirculatory changes associated with increasing severity of liver cirrhosis. / Methods: Forty patients with liver cirrhosis were studied and divided into groups based on Child‐Pugh classes A (n = 9), B (n = 18), and C (n = 13) for comparison. Incident dark field imaging was used to evaluate the sublingual microcirculation and near‐infrared spectroscopy at the thenar eminence to assess microvascular reactivity and function. / Results: There was no difference in microcirculatory flow index (P = 0.655), heterogeneity index (P = 0.702), or vessel density (P = 0.923) between the different Child‐Pugh groups. Microvascular reactivity did not change as the severity of liver disease worsened. / Conclusions: This study showed no association between peripheral systemic microcirculatory alterations and the severity of liver disease. Further research with larger study cohorts are needed to clarify the relationship between microcirculatory abnormalities and disease progression and to establish if the peripheral microcirculation is affected by the pathophysiology of worsening cirrhosis.

Type: Article
Title: Observational study of the microcirculation in patients with liver cirrhosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/jgh3.12196
Publisher version: https://doi.org/10.1002/jgh3.12196
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10085737
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