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Nitroglycerine effects on portal vein mechanics and oxidative stress in portal hypertension

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Author(s): Andreja Vujanac | Vladimir Jakovljevic | Dusica Djordjevic | Vladimir Zivkovic | Mirjana Stojkovic | Dragan Celikovic | Nebojsa Andjelkovic | Aleksandra Jurisic Skevin | Dragan Djuric

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 18;
Issue: 4;
Start page: 331;
Date: 2012;
Original page

Keywords: Portal hypertension | Endothelium | Nitroglycerine | Oxidative stress | Portal vein haemodynamics

ABSTRACT
AIM: Тo examine the effects of nitroglycerine on portal vein haemodynamics and oxidative stress in patients with portal hypertension. METHODS: Thirty healthy controls and 39 patients with clinically verified portal hypertension and increased vascular resistance participated in the study. Liver diameters, portal diameters and portal flow velocities were recorded using color flow imaging/pulsed Doppler detection. Cross-section area, portal flow and index of vascular resistance were calculated. In collected blood samples, superoxide anion radical (O2-), hydrogen peroxide (H2O2), index of lipid peroxidation (measured as TBARS) and nitric oxide (NO) as a marker of endothelial response (measured as nitrite-NO2-) were determined. Time-dependent analysis was performed at basal state and in 10th and 15th min after nitroglycerine (sublingual 0.5 mg) administration. RESULTS: Oxidative stress parameters changed significantly during the study. H2O2 decreased at the end of study, probably via O2- mediated disassembling in Haber Weiss and Fenton reaction; O2- increased significantly probably due to increased diameter and tension and decreased shear rate level. Consequently O2- and H2O2 degradation products, like hydroxyl radical, initiated lipid peroxidation. Increased blood flow was to some extent lower in patients than in controls due to double paradoxes, flow velocity decreased, shear rate decreased significantly indicating non Newtonian characteristics of portal blood flow. CONCLUSION: This pilot study could be a starting point for further investigation and possible implementation of some antioxidants in the treatment of portal hypertension.

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