Study of endothelin in portal hypertension

ABSTRACT

The aim of this study was to evaluate the plasma level of endothelin -1 in portal hypertension in patients with hepatic cirrhosis. Thirty patients with portal hypertension due to cirrhotic liver were studied at the Critical Care Medicine and Internal Medicine departments at Alexandria Main University Hospital. Clinical evaluation of the severity of illness was done using Modified Child- Pugh Score and portal hypertension was assessed by doing Duplex Doppler ultrasonogram. Plasma levels of endothelin-1 [ET-1] were estimated by radioimmunoassay. Plasma levels of endothelin-1 [ET-1] were significantly higher in patients with portal hypertension than control group [mean +/- SD was 94.3 +/- 14.91, 33.8 +/- 5.39 ng/ml respectively, p=.000]. Also, the study showed that plasma levels of ET-1 were significantly higher in patients with ascites than without [mean +/- SD was 104.15 +/- 11.71, 86.77 +/- 12.68 ng/ml respectively, p= .001]. The levels of ET-1 were significantly higher with the increased severity of liver disease according to modified Child -Pugh score [F = 10.25, p = .005]. Plasma ET-1 concentrations were increased in patients with portal hypertension with or without ascites, compared with controls. Patients with cirrhosis and ascites have increased ET-1 concentrations compared with those without ascites. The degree of increasing of plasma levels of endothelin was related to the severity of liver disease. The result of the present work may be of help in understanding the mechanism and may open a new field in the management of portal hypertension