In cirrhosis, in splanchnic arteries, endothelium-dependent relaxation may persist even if overactive nitric oxide synthase (NOS) and cyclooxygenase (COX) are inhibited. In normal arteries, a significant endothelium-dependent relaxation to acetylcholine persists after NOS/COX inhibition. This relaxation is caused by smooth muscle cell (SMC) membrane hyperpolarization, which is sensitive to a combination of the potassium channel blockers apamin and charybdotoxin, and is mediated by an endothelium-derived hyperpolarizing factor (EDHF). The aim of this study was to detect EDHF and evaluate its pathophysiologic role in isolated superior mesenteric arteries from cirrhotic rats. Arterial rings were obtained and exposed to N w -nitro-L-arginine (L-NNA, a NOS inhibitor) and indomethacin (a COX inhibitor). Acetylcholine-induced membrane potential responses and concentration-response curves to the relaxant of acetylcholine were obtained with and without apamin plus charybdotoxin. Acetylcholine-induced responses were measured in certain rings from endothelium-denuded arteries. Contractions caused by the ␣ 1 -adrenoceptor agonist phenylephrine were obtained in cirrhotic and normal rings with and without apamin and charybdotoxin. Significant acetylcholine-induced, endothelium-dependent, apamin-and charybdotoxin-sensitive, SMC membrane hyperpolarization and relaxation were found. An apamin-and charybdotoxinsensitive hyporesponsiveness to the contractile action of phenylephrine was found in cirrhotic rings. In conclusion, in cirrhotic rats, in the superior mesenteric artery exposed to NOS/COX-inhibitors, an EDHF exists that may replace NOS/COX products to induce endothelium-dependent arterial relaxation. (HEPATOLOGY 2000;32:935-941.)In portal hypertension, in splanchnic and systemic arteries, certain mechanisms induce endothelium-dependent smooth muscle cell (SMC) relaxation and hyporeactivity to vasoconstrictors by activating endothelial nitric oxide synthase (NOS) and cyclooxygenase (COX) to produce nitric oxide (NO) and prostacyclin (PGI 2 ). 1-12 However, it has been shown that, in portal hypertensive rats, NOS inhibition, alone or combined with COX inhibition, did not suppress arterial SMC relaxation and hyporeactivity to vasoconstrictors. 3,4,6,8 These findings show that a NOS/COX-inhibitor-insensitive SMC relaxation may be involved in arterial alterations associated with portal hypertension. It should be kept in mind that, in normal arteries, a significant endothelium-dependent arterial SMC relaxation (caused by shear stress or acetylcholine) persists even after NOS/COX inhibition. [13][14][15][16][17] This NOS/COX-inhibitor-insensitive relaxation is caused by SMC membrane hyperpolarization caused by endothelium-derived hyperpolarizing factors (EDHFs). 15,[17][18][19][20] In normal splanchnic arteries, a combination of the K ϩ channel blockers, apamin and charybdotoxin, 21 is known to inhibit EDHF-induced SMC hyperpolarization and relaxation. [22][23][24][25][26] In addition, a combination of barium (a K ϩ channel block...