Mean arterial pressure drop is an independent risk factor of death in patients with HBV-related cirrhosis ascites

Mean arterial pressure drop is an independent risk factor of hepatorenal syndrome in patients with HBV-ACLF

“…A significant change in patients with cirrhosis is portal hypertension, which accelerates the release and generation of endogenous vasodilators into visceral blood circulation. The release of these vasodilators results in splanchnic vasodilatation, blood volume expansion and increased mesenteric blood flow [ 3 , 13 , 22 ]. Finally, the total effective arterial blood volume decreases, and leads to systemic circulatory dysfunction.…”

“…The vasodilatory complications of hepatorenal syndrome and hepatopulmonary syndrome can be prevented in patients with high arterial blood pressure [ 13 ]. MAP is regarded as the perfusion pressure required maintaining blood flow to the organs and is considered the most important hemodynamic measure of the function of the circulation system [ 13 ]. MAP is also the determining factor for maintaining cerebral and renal blood flow [ 16 , 18 ].…”

“…Low MAP is also closely associated with hyperdynamic circulation, seroperitoneum and advancement of hepatorenal syndrome, indicating that optimal MAP may be an important prognostic factor in patients with liver cirrhosis ascites [15][16][17][18]. In a prospective cohort study, the long-lasting impact of baseline MAP levels on the prognosis of patients with hepatitis B virus (HBV)-related cirrhosis ascites was demonstrated [13]. More specifically, a decrease in MAP was a valuable predictor of death in patients with HBV-related liver cirrhosis ascites [13].…”

“…While most current biomarker studies are performed in alcoholic liver disease. Creatinine, which is the main component of previous HRS predict models, is affected by many factors associated with creatinine generation and excretion [ 13 ], and is a delayed and insensitive biomarker of renal function but not kidney injury [ 14 ]. Other biomarkers primarily reflect the severity of chronic liver disease or are difficult to follow-up and observe clinically, so they cannot be effectively used for clinical evaluation.…”

“…In a prospective cohort study, the long-lasting impact of baseline MAP levels on the prognosis of patients with hepatitis B virus (HBV)-related cirrhosis ascites was demonstrated [ 13 ]. More specifically, a decrease in MAP was a valuable predictor of death in patients with HBV-related liver cirrhosis ascites [ 13 ]. Together, these studies indicate that MAP may be useful for determining the prognosis and exploring new treatment measures for liver cirrhosis ascites [ 13 ].…”