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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Out of all until now discovered natriuretic factors it is still the atrial natriuretic factor (ANF) which is the most significant with its diuretic, natriuretic and vasodilatory effects. Its effect is antagonistic to sodium retention factors. The increase of its levels in arterial hypertension is more of secondary character, but according to some authors the functional deficit of ANF secretion can be applied also primarily in the development and maintenance of high blood pressure. ANF levels represent a good marker of the clinical severeness and are of prognostic value. Increased levels were detected also in cases of renal failure and partially in hepatic cirrhosis. Natriuretic hormone, in comparison to ANF, is a natriuretic and vasoconstrictive substance, the effect of which is based on the mechanism of sodium pump inhibition. Chemically the main candidate is represented by endogenous ouabain, or a digitalis-like activity. It increases physiologically due to the expansion of extracellular fluid during gravidity and in newborn. Its pathological increase is brought about by some forms of essential hypertension and in the diseases associated with fluid retention and edema development. Cirrhosis of the liver can reflect both the degree of sodium retention and haemodilution, as well as the severeness of hepatic lesion. (Tab. 2, Ref. 30.).
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PMID:[The clinical significance of natriuretic hormones]. 862 37

Alcoholism may lead to a great many physical and mental problems in individuals of any age. Elderly alcoholics often have additional problems resulting from the interaction of age related changes in physiology and "heavy" alcohol intake. Some of the more important problems are: Impairment of the immune system with decreased ability to deal with infection or cancer. Increased incidence of hypertension, cardiac arrhythmia, myocardial infarction, and cardiomyopathy. Increased incidence of stroke. Alcohol dementia. Increased incidence of esophageal and other cancers. Cirrhosis and other liver disease. Malnutrition. There seems to be no area in which even moderate alcohol intake is of definite benefit, and some areas in which even small amounts are detrimental.
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PMID:Medical manifestations of alcoholism in the elderly. 875 18

This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation and neurohumoral dysregulation found in cirrhosis. Recent studies have shown that the ET system is highly activated in most cirrhotic patients. Circulating ET-1 and ET-3 levels have a positive relation to the severity of the disease and fluid retention, with the highest values recorded in patients with functional renal failure. Studies on liver biopsies have revealed synthesis of ET-1 in hepatic endothelial and other cells, and recent investigations have identified the hepatosplanchnic system as a major source of ET-1 and ET-3 spillover into the circulation, with a direct relation to portal venous hypertension. In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive and antinatriuretic regulatory systems (i.e. the sympathetic nervous system, renin-angiotensin-aldosterone and vasopressin) are apparent, with respect to kinetics and haemodynamic dysregulation. Cirrhosis seems to be a pathophysiological condition with indications of the occurrence of ETs, not only as local modulators, but also as a system with potential importance for systemic regulation.
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PMID:Endothelins in chronic liver disease. 890 9

Alcohol is one of the most widely used addictive substances. It can be assumed that everybody encounters alcohol--ethanol in various forms and concentrations in the course of their lives. A global and social problem of our civilization is alcohol consumption which has a rising trend. Since 1989 the consumption of alcoholic beverages is rising and the mean annual consumption of concentrated ethanol per head is cea 10 litres. In ethanol abuse the organism is damaged not only by ethanol alone but in particular by substances formed during its metabolism. Its detailed knowledge is essential for the knowledge and investigations of the metabolic and toxic effect of ethanol on the organism. Ingested alcohol is in 90-98% eliminated from the organism by three known metabolic pathways: 1-alcohol dehydrogenase, 2-the microsomal ethanol oxidizing system and 3-catalase. Alcohol is a frequent important risk factor of serious "diseases of civilization" such as IHD, hypertension, osteoporosis, neoplastic diseases. Cirrhosis of the liver and chronic pancreatitis are the well known diseases associated with alcohol ingestion and also their most frequent cause. It is impossible to list all organs and diseases which develop as a result of alcohol consumption. It is important to realize that regular and "relatively" small amounts in the long run damage the organism and may be even fatal.
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PMID:[Alcohol]. 892 47

The authors present a case of tyrosinemia type 1, 3 years old girl at the time of diagnosis. The presenting symptoms were 3 times colic, obstipation, acute encephalopathy, hypertension, hyponatremia, according to the porphyric crisis. Her kidney function tests gave normal results during illness, only once an increased calcium turnover was observed. She has no singe of rachitis. Cirrhosis of the liver was proved by biopsy because of progressively rising gammaGT and alfa-fetoprotein levels. A new ensime-blocker (NTBC) treatment was started in an international collaboration. The authors compare the history of this case to that of others published in the literature. They summarize the pathomechanism of the disease.
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PMID:[Late onset type I tyrosinemia]. 928 Aug 76

Cirrhosis represents the end-stage of any chronic liver disease. Two major syndromes result from cirrhosis-portal hypertension and hepatic insufficiency. Additionally, vasodilatation and the hyperdynamic circulation are hemodynamic abnormalities typical of cirrhosis and portal hypertension. Complications of cirrhosis occur as a consequence of a combination of these factors. Gastroesophageal varices result almost solely from portal hypertension, although the hyperdynamic circulation contributes to variceal growth and hemorrhage. Ascites results from sinusoidal hypertension and sodium retention, which is, in turn, secondary to vasodilatation and activation of neurohumoral systems. Hepatorenal syndrome also results from severe peripheral vasodilatation that leads to renal vasoconstriction. Another complication of cirrhosis, portosystemic encephalopathy, is a consequence of both portal hypertension (shunting of blood through portosystemic collaterals) and hepatic insufficiency. In this article, recent advances in pathophysiology and management of the complications of cirrhosis and portal hypertension are reviewed.
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PMID:Portal hypertension. 1702 87

Cirrhosis represents the end stage of any chronic liver disease. Two major syndromes result from cirrhosis: portal hypertension and hepatic insufficiency. Additionally, vasodilatation and the hyperdynamic circulation are hemodynamic abnormalities typical of cirrhosis and portal hypertension. Complications of cirrhosis occur as a consequence of a combination of these factors. Gastroesophageal varices result almost solely from portal hypertension, although the hyperdynamic circulation contributes to variceal growth and hemorrhage. Ascites results from sinusoidal hypertension and sodium retention, which is, in turn, secondary to vasodilatation and activation of neurohumoral systems. Hyponatremia and the hepatorenal syndrome result from water retention and renal vasoconstriction, respectively, both of which are also consequences of peripheral vasodilatation. Vasodilatation that occurs in the pulmonary circulation leads to the hepatopulmonary syndrome. Another complication of cirrhosis, portosystemic encephalopathy, is a consequence of both portal hypertension (shunting of blood through portosystemic collaterals) and hepatic insufficiency. This paper reviews the recent advances in the pathophysiology and management of the complications of cirrhosis and portal hypertension.
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PMID:Portal hypertension. 1702 54

End-stage liver disease and its complications are a leading cause of death among adults in the United States, and thousands of patients await liver transplantation. The liver plays a central role in health and homeostasis and thus the diseased liver leads to many deleterious effects on multiple organ systems, including the pulmonary system. We review the general effects of cirrhosis on the respiratory system, including mild hypoxemia, atelectasis, and hepatic hydrothorax. Cirrhosis is associated with 2 unique entities that affect the pulmonary vasculature: hepatopulmonary syndrome and portopulmonary hypertension. Hepatopulmonary syndrome, which is found in approximately 20% of patients awaiting liver transplantation, refers to the triad of hepatic dysfunction, hypoxemia, and intrapulmonary vascular dilations, and responds well to liver transplantation. In portopulmonary hypertension, cirrhosis and portal hypertension lead to pulmonary arterial hypertension, and portopulmonary hypertension has been considered a contraindication for transplantation. Currently, patients must have mild to moderate pulmonary hypertension to be considered for transplantation, and may still require long-term therapy with vasodilators to prevent right-ventricular failure and, consequently, failure of the newly transplanted liver allograft.
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PMID:Respiratory dysfunction and pulmonary disease in cirrhosis and other hepatic disorders. 1765 Mar 60

Cirrhosis associated with moderate and severe portopulmonary hypertension carries a poor prognosis. Optimal management has not yet been defined. Current treatment options, such as prostacyclin analogues, endothelin antagonists, and phosphodiesterase-5 inhibitors, are characterized by slow onset of action and various adverse effects, particularly in patients with advanced cirrhosis. Here, we report the significant reduction of pulmonary arterial pressure after 1-week terlipressin treatment in a patient with concomitant hepato-renal syndrome. Terlipressin could be a novel and safe treatment for portopulmonary hypertension.
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PMID:Significant improvement of portopulmonary hypertension after 1-week terlipressin treatment. 1828 Jun 5

In this study, we describe the development of acute pulmonary oedema and cardiac arrest after therapeutic ascitic paracentesis, in a gentleman with decompensated liver cirrhosis. There was no previous history of cardiorespiratory symptoms or disease. Postmortem examination revealed oedematous and congested lungs with bilateral pleural effusions; in addition, the right heart was dilated and congested. Micronodular cirrhosis was present with histological features of alpha1 antitrypsin deficiency. This is the first study of acute cardiac decompensation after large volume paracentesis. Owing to the postmortem findings, underlying asymptomatic cardiorespiratory disease may have been present. Cirrhosis is associated with cardiovascular complications including cirrhotic cardiomyopathy, portopulmonary hypertension and hepatopulmonary syndrome which may manifest or worsen under situations of haemodynamic stress. This report thus raises the question whether routine screening for cardiovascular abnormalities is warranted in patients with decompensated cirrhosis, particularly before the procedures such as paracentesis that impose significant haemodynamic strain.
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PMID:Pulmonary oedema after therapeutic ascitic paracentesis: a case report and literature review of the cardiac complications of cirrhosis. 2063 44


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