Plasma Endothelin-1 Level in Patients With Schistosomal and Post Viral Liver Cirrhosis With Portal Hypertension :Its Relation to Portal Haemodynamics and Risk of Bleeding

Abstract

Schistosmiasis and post viral cirrhosis constitute a maJor health problem in Egypt. Portal hypertension is one of the most serious complication of chronic liver disease. It manifests clinically as ascites, splenomegaly variceal bleeding and porto-systemic encephalopathy. Several factors have been attributed in the pathogenesis of portal hypertension. Variceal bleeding is the most common cause of morbidity and mortality .in portal hypertensive patients.

Endothelin-1 (Et-1) is 21 aminoacid peptide mainly produced by endothelial cells with the vascular endothelium being the most abundant source of it. It is a very potent vasoconstrictor for both systemic and portal circulation. Plasma Et-1 level was found to be significantly elevated in patients with liver cirrhosis. Et-1 induces portal venous vasoconstriction and hence may play a role in increasing portal venous pressure I.e. aggravation of portal hypertension in liver cirrhosis.