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

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 (O(2) (-)), hydrogen peroxide (H(2)O(2)), index of lipid peroxidation (measured as TBARS) and nitric oxide (NO) as a marker of endothelial response (measured as nitrite-NO(2) (-)) 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. H(2)O(2) decreased at the end of study, probably via O(2) (-) mediated disassembling in Haber Weiss and Fenton reaction; O(2) (-) increased significantly probably due to increased diameter and tension and decreased shear rate level. Consequently O(2) (-) and H(2)O(2) 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.