Cardiovascular abnormalities in obstructive cholestasis: the possible mechanisms

Authors

  • Leila Moezi,

    1. Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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  • Ahmad R. Dehpour

    Corresponding author
    1. Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
    • Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Correspondence

Professor Ahmad Reza Dehpour, Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran

Tel.: +98 21 889 73 652

Fax: +98 21 664 02 569

e-mail: dehpour@yahoo.com

Abstract

Cholestatic liver disease is associated with widespread derangements in the cardiovascular system, such as bradycardia, hypotension, QT prolongation and peripheral vasodilation; it is also associated with increased susceptibility to postoperative renal failure and haemorrhagic shock. A number of cellular signalling pathways have been shown to contribute to these abnormalities. In this article, we briefly review recent in vivo and in vitro findings in the field in an attempt to highlight the areas of agreement and areas of controversy. In this review, we will summarize pathogenic mechanisms underlying cardiac and vascular abnormalities in obstructive cholestasis. It seems that cardiovascular dysfunction is likely because of bile acids as one of the predominant factors. Other important factors which might play roles in these abnormalities are increased nitric oxide, endogenous opioids and endocannabinoids. These three factors interact with each other to exert vasodilation and impaired cardiovascular responses to sympathetic stimulation.

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