Peripheral endothelial and microvascular damage in liver cirrhosis: A systematic review and meta-analysis

IF 1.9 4区医学 Q3 HEMATOLOGY Microcirculation Pub Date : 2022-06-02 DOI:10.1111/micc.12773

Ioanna Papagiouvanni, Marieta P. Theodorakopoulou, Pantelis A. Sarafidis, Emmanouil Sinakos, Ioannis Goulis

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Abstract

Objective

This is the first systematic review and meta-analysis of studies using any available functional method to examine differences in peripheral endothelial function between cirrhotic and non-cirrhotic individuals.

Methods

Literature search involved PubMed, Web-of-Science, and Scopus databases, as well as gray literature sources. We included studies in adult subjects evaluating endothelial function with any semi-invasive or non-invasive functional method in patients with and without liver cirrhosis.

Results

From 3378 records initially retrieved, 15 studies with a total of 570 participants were included in the final quantitative meta-analysis. In six studies examining endothelial function with flow-mediated-dilatation, no differences between patients with cirrhosis and controls were evident (WMD: 1.33, 95%CI [−2.87, 5.53], I² = 97%, p < .00001). Among studies assessing differences in endothelial-dependent or endothelial-independent vasodilation with venous-occlusion-plethysmography, there were no significant differences between the two groups. When pooling all studies together, regardless of the technique used, no significant difference in endothelial function between cirrhotic patients and controls was observed(SMD: 0.79, 95%CI[−0.04, 1.63], I² = 94%, p < .00001).

Conclusions

No differences in peripheral endothelial function assessed with semi-invasive or non-invasive functional methods exist between cirrhotic and non-cirrhotic subjects. The increasing co-existence of cardiovascular risk factors leading to impaired vascular reactivity in cirrhotic patients may partly explain these findings.

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肝硬化外周内皮和微血管损伤:一项系统综述和荟萃分析

目的:这是第一个系统回顾和荟萃分析的研究，使用任何可用的功能方法来检查肝硬化和非肝硬化患者外周血管内皮功能的差异。方法文献检索包括PubMed、Web-of-Science、Scopus等数据库以及灰色文献。我们纳入了成人受试者的研究，用任何半侵入性或非侵入性功能方法评估有或无肝硬化患者的内皮功能。从最初检索的3378份记录中，最终的定量荟萃分析纳入了15项研究，共570名参与者。在6项通过血流介导的扩张检查内皮功能的研究中，肝硬化患者与对照组之间无明显差异(WMD: 1.33, 95%CI [- 2.87, 5.53]， I2 = 97%， p < 0.00001)。在评估内皮依赖性或内皮非依赖性血管舒张与静脉闭塞容积描记术的差异的研究中，两组之间没有显著差异。当将所有研究合并在一起时，无论使用何种技术，肝硬化患者和对照组之间的内皮功能没有显著差异(SMD: 0.79, 95%CI[- 0.04, 1.63]， I2 = 94%， p < 0.00001)。结论:采用半侵入性或非侵入性功能方法评估的肝硬化和非肝硬化患者外周血管内皮功能无差异。导致肝硬化患者血管反应性受损的心血管危险因素的增加共存可能部分解释了这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.