{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:20:41Z","timestamp":1747149641254,"version":"3.40.5"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T00:00:00Z","timestamp":1558656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Liver cirrhosis is associated with widespread microcirculatory dysfunction and hemodynamic derangement, which may play a role in the pathogenesis of multiple organ failure. Little is known, however, about the progression of microvascular alterations as the severity of liver disease worsens. Therefore, our aim is to quantify the peripheral systemic microcirculatory changes associated with increasing severity of liver cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty patients with liver cirrhosis were studied and divided into groups based on Child\u2010Pugh classes A (<jats:italic>n<\/jats:italic> = 9), B (<jats:italic>n<\/jats:italic> = 18), and C (<jats:italic>n<\/jats:italic> = 13) for comparison. Incident dark field imaging was used to evaluate the sublingual microcirculation and near\u2010infrared spectroscopy at the thenar eminence to assess microvascular reactivity and function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference in microcirculatory flow index (<jats:italic>P<\/jats:italic> = 0.655), heterogeneity index (<jats:italic>P<\/jats:italic> = 0.702), or vessel density (<jats:italic>P<\/jats:italic> = 0.923) between the different Child\u2010Pugh groups. Microvascular reactivity did not change as the severity of liver disease worsened.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study showed no association between peripheral systemic microcirculatory alterations and the severity of liver disease. Further research with larger study cohorts are needed to clarify the relationship between microcirculatory abnormalities and disease progression and to establish if the peripheral microcirculation is affected by the pathophysiology of worsening cirrhosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.12196","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T16:00:00Z","timestamp":1558713600000},"page":"518-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Observational study of the microcirculation in patients with liver cirrhosis"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1310-1954","authenticated-orcid":false,"given":"Stephen","family":"Wythe","sequence":"first","affiliation":[{"name":"University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre Institute of Sport and Exercise Health  London UK"},{"name":"Department of Intensive Care Royal Free Hospital Pond Street  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas W","family":"Davies","sequence":"additional","affiliation":[{"name":"University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre Institute of Sport and Exercise Health  London UK"},{"name":"Department of Intensive Care Royal Free Hospital Pond Street  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"O'Beirne","sequence":"additional","affiliation":[{"name":"Department of Hepatology Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service  Brisbane Queensland Australia"},{"name":"University of the Sunshine Coast  Sunshine Coast Region Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Martin","sequence":"additional","affiliation":[{"name":"University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre Institute of Sport and Exercise Health  London UK"},{"name":"Department of Intensive Care Royal Free Hospital Pond Street  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Gilbert\u2010Kawai","sequence":"additional","affiliation":[{"name":"University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre Institute of Sport and Exercise Health  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32866-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1504367"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181572357"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.3532"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20993"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000155552.14396.3d"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.09.013"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199708000-00012"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840170507"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840170210"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280510"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280107"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)00035-0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/micc.12448"},{"key":"e_1_2_6_16_1","first-page":"1","article-title":"The microcirculation is the motor of sepsis","volume":"9","author":"Ince C","year":"2005","journal-title":"Crit. 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